Director of Revenue and Reimbursement
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. The role drives operational excellence across billing, coding, claims management, cash posting, accounts receivable, denial resolution, and revenue integrity. The Director collaborates with clinical, financial, and operational teams to optimize reimbursement while maintaining compliance and accuracy. This leadership position combines revenue cycle strategy, operational oversight, analytics, compliance, and team development. It offers direct partnership with the CFO and an opportunity to influence financial outcomes and improve reimbursement performance and operational efficiency.
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
- A bachelor's degree in Business, Finance, Accounting, Healthcare Information Management, Information Systems, Mathematics, Statistics, or a related field is 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 revenue cycle performance indicators, including days in accounts receivable, clean claim rate, denial rate, and net collection rate.
- Partner with outsourced service providers to support 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; partner with the CFO on revenue performance and forecasting.
- Provide direction to internal billing, coding, and cash posting staff, establish performance expectations, and promote continuous improvement.
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What This Job Offers
Job Type
Full-time
Career Level
Director
