Director of RCM Services

Practice By Numbers•Remote US,

5d•$150,000 - $180,000•Remote

About The Position

Practice by Numbers is hiring its first Director of RCM Services to build a revenue cycle management business from the ground up. There is no existing RCM team, operation, or playbook. The Director will develop the service, build an organization across the United States and India, establish operating standards, and own revenue growth. This person will serve as the company’s senior dental RCM authority, guide the executive team, and turn the business plan into a functioning service. The role includes providing a complete revenue cycle service, including pre-visit insurance verification, claims, payment posting, denial management, appeals, and follow-up on patient balances after insurance payment. The service will be delivered by PbN employees trained to a common standard and working directly in each client’s existing dental software. Verification will be priced transparently as a separate line item. Initial growth is expected to come from existing PbN customers, with expansion beyond that customer base after the first year. The Director will design the US customer-facing organization and India delivery operation, establish how responsibilities are divided between the countries, hire the Senior Manager of RCM Operations in India, and help recruit and train the first Gurgaon delivery team. The role will also create playbooks, SOPs, training materials, management routines, workflows, and service standards, with automation in mind. The Director will own client relationships, RCM revenue, service performance, and core metrics including adoption, denial rate, first-pass acceptance, accounts receivable over 90 days, and net collections. This is a US-based remote position, with a hybrid option from the Redmond, Washington office for candidates based in Washington. Significant travel to Gurgaon, India is required, including several trips and extended early stays during the first year for hiring, training, and setting up the delivery operation. After the first year, travel is expected to be about three or four visits annually, or as needed. The position reports to the Head of Customer Experience.

Requirements

Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, Health Information Management, or a related field.
At least 8 years of experience in dental revenue cycle management, including leading a team of 200 or more or managing a large portfolio of practices.
Demonstrated revenue growth within an existing customer base; experience adding services to established software relationships is especially relevant.
Hands-on CDT expertise, including the ability to review clinical notes and assess whether documentation supports the coding.
Detailed knowledge of PPO plan design, including annual maximums, waiting periods, frequency limits, downgrades, missing-tooth clauses, and replacement clauses.
Daily working experience with at least two of Dentrix, Eaglesoft, Open Dental, and Ascend.
Direct experience hiring, training, or running an offshore delivery team in India or a comparable market, with operational ownership beyond vendor oversight.
Strong writing skills for SOPs, appeal letters, and training materials, and the ability to design processes with automation in mind.
Ability and willingness to meet the significant India travel requirement.

Nice To Haves

An MBA, Master of Health Administration (MHA), or related master's degree.
DSO or group-practice central billing experience.
Experience establishing a service or delivery center from scratch.
Familiarity with hiring in India.

Responsibilities

Provide a complete revenue cycle service covering pre-visit insurance verification, claims, payment posting, denial management, appeals, and patient-balance follow-up after insurance payment.
Make detailed, patient-specific insurance verification a core service component by researching payer portals and contacting payers to identify plan limits, waiting periods, downgrade clauses, and applicable employer-group fee schedules.
Establish clear ownership and processes for patient-balance follow-up to manage aging balances and potential write-offs.
Design the customer-facing team in the US, including roles for practice relationships, onboarding, service communications, and escalations.
Determine which functions and activities are handled in the US and India, and define responsibilities, decision authority, handoffs, and escalation paths.
Hire the Senior Manager of RCM Operations in India and jointly recruit, train, and establish the first delivery team in Gurgaon.
Define customer service and support hours, time-zone coverage, and staffing requirements; develop India shift patterns, capacity plans, and coordination practices with the Senior Manager.
Create operating playbooks, SOPs, training materials, and management routines, including materials for appeals and training, with automation in mind.
Own RCM revenue and grow adoption among existing software customers in partnership with the teams managing those customer relationships.
Lead practice-level financial reviews, identify billing and collection opportunities, and develop service proposals and pricing based on practice data.
Build workflows for verification, claims, payment posting, denials, appeals, and patient collections, and set client-facing service standards.
Serve as the coding and escalation authority for CDT, clinical documentation, narratives, attachments, and appeals, providing hands-on guidance on complex cases.
Own relationships with the initial RCM clients and hold delivery teams accountable for service commitments.
Own and manage core performance metrics, including attach rate, denial rate, first-pass acceptance, accounts receivable over 90 days, and net collections.
Travel to Gurgaon, India for in-person hiring, training, delivery-operation setup, and ongoing leadership visits.