Director of Revenue and Reimbursement

Mp Rpo•Wolfeboro, NH

About The Position

The Director of Revenue and Reimbursement oversees back-end revenue cycle operations for a healthcare organization and reports directly to the CFO. This leader drives operational excellence across billing, coding, claims management, cash posting, accounts receivable, denial resolution, and revenue integrity. The role combines operational leadership, analytics, compliance, and team development to improve reimbursement and financial performance while maintaining accuracy and regulatory compliance. The Director partners with outsourced service providers and cross-functional teams, including Patient Access and Decision Support, and provides direction to internal billing, coding, and cash posting staff. The position offers leadership visibility and direct partnership with the CFO, with the opportunity to influence revenue cycle strategy and financial outcomes.

Requirements

At least 7 years of relevant healthcare experience, with strong knowledge of revenue cycle operations and healthcare reimbursement.
In-depth knowledge of HCPCS and ICD-10 coding, reimbursement practices, and applicable regulatory requirements.
Experience analyzing financial information, interpreting financial statements, and using revenue cycle data to improve performance.
Strong understanding of billing, claims, collections, and revenue cycle information systems.
Ability to connect clinical documentation, coding, billing, and financial processes to improve compliance and maximize reimbursement.
Experience managing teams, third-party vendors, and cross-functional relationships.
Strong analytical, organizational, communication, and problem-solving skills.

Nice To Haves

Bachelor's degree in Business, Finance, Accounting, Healthcare Information Management, Information Systems, Mathematics, Statistics, or a related field preferred.
Preferred certifications: RHIA, RHIT, RN, CPC, CPC-H, CCS, or CCS-P.

Responsibilities

Oversee billing, coding, charge capture, claims submission, cash posting, and accounts receivable.
Monitor and improve key performance indicators, including days in A/R, clean claim rate, denial rate, and net collection rate.
Partner with outsourced service providers to ensure timely claims submission, effective follow-up, and resolution of aging accounts and underpayments.
Oversee ICD-10, CPT, and HCPCS coding processes, audits, and corrective action initiatives.
Analyze denial trends, identify root causes, and implement strategies to reduce recurring denials and revenue leakage.
Ensure accurate payment posting, contractual adjustments, cash reconciliation, and accounts receivable reporting.
Partner with Patient Access and Decision Support teams to improve charge capture, pricing estimates, and reimbursement accuracy.
Manage bad debt and financial assistance workflows, vendor relationships, write-offs, and appropriate account classifications.
Own revenue cycle dashboards, reporting, and analytics, and partner with the CFO on revenue performance and forecasting.
Direct internal billing, coding, and cash posting staff, establish performance expectations, and promote continuous improvement.