Director of Reimbursement

OrthoArkansas•Little Rock, AR

2d•Onsite

About The Position

The Director of Reimbursement at OrthoArkansas provides strategic leadership and operational oversight for the organization's entire Revenue Cycle function. Reporting to executive leadership, this position is responsible for the financial performance, compliance, and continuous improvement of billing and reimbursement operations supporting more than 100 providers across multiple specialties, clinic locations, surgery centers, and ancillary service lines. The Director of Reimbursement oversees departmental leadership, payer relationships, revenue cycle technology, regulatory compliance, and organizational reimbursement strategy while driving operational excellence and maximizing financial performance. This role serves as the organization's subject matter expert on reimbursement, payer policy, and revenue cycle best practices.

Requirements

Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field required.
Minimum of 7–10 years of progressive Revenue Cycle leadership experience.
Minimum of 3 years of director-level or comparable leadership experience overseeing large Revenue Cycle operations.
Demonstrated experience managing multi-specialty physician billing operations.
Expert knowledge of the complete healthcare Revenue Cycle, including registration, coding, billing, collections, denial management, and reimbursement.
Strong understanding of CMS regulations, commercial payer requirements, ICD-10, CPT, HCPCS, and reimbursement methodologies.
Proven ability to lead large teams while driving measurable operational improvements.
Excellent analytical, organizational, and strategic planning skills.
Outstanding communication and presentation skills with the ability to effectively engage executive leadership and physicians.
Demonstrated success leading organizational change, technology implementations, and process improvement initiatives.
Strong leadership skills with the ability to develop leaders, foster accountability, and build high-performing teams.
Interest in leveraging Artificial Intelligence (AI) to improve Revenue Cycle performance and operational efficiency.
Advanced: Revenue Cycle Management Systems, Practice Management Systems, Database Management, Spreadsheet Applications, Word Processing, Presentation Software
Intermediate: Electronic Health Records (EHR), Business Intelligence and Reporting Tools, Contact Management Systems

Nice To Haves

Experience supporting ambulatory surgery center and imaging reimbursement strongly preferred.
Experience leading payer audits, regulatory reviews, and large-scale operational initiatives preferred.
AI-powered Revenue Cycle platforms, denial analytics software, prior authorization automation tools, data visualization platforms

Responsibilities

Lead the overall Revenue Cycle strategy to maximize reimbursement, improve operational efficiency, and support organizational growth.
Monitor and analyze key performance indicators including net collection rate, days in accounts receivable, clean claim rate, denial rates, cash collections, and reimbursement trends.
Develop long-term revenue cycle strategies that support new providers, new clinic locations, surgery centers, imaging services, and future service line expansion.
Present revenue cycle performance, financial trends, operational initiatives, and strategic recommendations to executive leadership.
Champion the adoption of Artificial Intelligence (AI) and automation technologies within Revenue Cycle, including prior authorization, denial management, coding support, and self-pay workflows.
Provide direct leadership to the Reimbursement Manager(s) and indirect oversight of departmental supervisors responsible for Coding, Insurance Collections, Pre-Certification, Financial Counseling/Self-Pay, and Ancillary Billing.
Establish performance expectations, accountability measures, and productivity standards across all revenue cycle functions.
Develop leadership talent through coaching, mentoring, succession planning, and ongoing professional development.
Collaborate with Human Resources on recruitment, onboarding, retention, compensation benchmarking, and performance management.
Develop business continuity plans and staffing strategies to maintain operational performance during workforce fluctuations.
Serve as the organization's primary liaison for complex payer relationships, escalated reimbursement issues, and contract-related concerns.
Oversee denial management strategies, root cause analysis, and organization-wide process improvement initiatives to reduce preventable denials.
Lead responses to payer audits, RAC/MAC reviews, OIG inquiries, and other regulatory examinations.
Monitor federal and state healthcare regulations, CMS guidance, HIPAA requirements, the No Surprises Act, and payer policy updates to ensure organizational compliance.
Partner with Compliance and Legal on reimbursement risks, overpayment demands, documentation standards, and regulatory initiatives.
Evaluate, implement, and optimize revenue cycle technologies that improve reimbursement accuracy, operational efficiency, and staff productivity.
Partner with Information Technology and software vendors to optimize EHR and Practice Management systems.
Lead continuous process improvement initiatives using operational data and performance metrics.
Develop standardized workflows, policies, training materials, and governance processes to improve consistency across the Revenue Cycle department.
Ensure successful implementation of new technology through staff training, adoption monitoring, and ongoing optimization.
Perform other related duties as assigned to support organizational financial performance and Revenue Cycle operations.