Director of Revenue Cycle Management (RCM)
McKinley Children's Center•San Dimas, CA
•Onsite
About The Position
The Director of Revenue Cycle Management (RCM) oversees county behavioral health billing and revenue cycle operations to ensure compliance with Medi-Cal, DHCS, County, State, Federal, and HIPAA Rules and Regulations. This position manages billing staff, ensures accurate and timely claims submission, oversees denial and appeal processes, and works closely with the VP of Compliance and Billing and Senior Leadership to support accurate revenue reporting and regulatory compliance.
Requirements
- Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or a related field preferred
- Experience in Behavioral Health or County Billing and Revenue Cycle Management
- 5+ years in Supervisory or Management Experience
- Strong knowledge of Medi-Cal Eligibility and Claims Processing
- Experience with County Billing Operations, including denials, violations, and appeals
- Knowledge of DHCS State Procedure Codes, Modifiers and Staff Taxonomy Codes
- Working knowledge of HIPAA Rules and Regulations related to billing, privacy, and data security
- Experience with EDI transactions and claim batching
- Advanced proficiency in Microsoft Excel (tracking, reconciliation, and reporting)
- Working knowledge of Microsoft Access or similar database tools
- Experience with County EHR systems, including IBHIS
- Strong analytical, tracking, and reporting skills
- Excellent written and verbal communication skills
- Ability to manage complex billing, compliance, and regulatory requirements
- Ability to represent the agency professionally and appropriately with internal and external county and state partners
- Must pass pre-employment physical exam, TB and drug screening
- Ability to commute to various sites on and off campus
- DOJ, FBI, Child Abuse Index clearances
- Insurability Under Corporate Automobile Insurance
Nice To Haves
- Preferred knowledge of Welligent EHR
Responsibilities
- Review program and clinical documentation for compliance with HIPAA, regulatory, county, and agency billing requirements, including DHCS procedure and taxonomy codes
- Assist service delivery and clinical staff with correcting billing violations, documentation deficiencies, and EHR billing errors
- Monitor, correct, and rebill denied claims
- Ensure accuracy of billing records, procedure codes, rates, and invoices
- Submit and manage electronic billing through county EHR systems, including Welligent, using EDI and EFT platforms
- Track and review EDI/EFT data (e.g., 835s, 837s) to monitor claim status and payments
- Develop and maintain billing and funding tracking systems
- Perform monthly billing reconciliation and resolve billing and invoice variances
- Ensure manual county billing is entered, submitted, and processed on time
- Identify training needs and provide training and oversight to billing staff
- Participate in required State and County quality or compliance meetings
- Report documentation and compliance concerns to the VP of Contract Compliance and Billing
- Collaborate with executive leadership and clinical teams to ensure billing accuracy and a high standard of care
- Supervise Billing Staff
- Other related duties as needed.
Benefits
- Medical, Dental, and Vision Insurance
- Life Insurance
- Flexible Spending Account
- Paid Time Off
- Sick Time
- Paid Holidays
- 403(b) retirement plan with company match up to 3%
- Employee Assistance Program
- Tuition Reimbursement
- Employee Referral Bonus
- Credit Union Membership
- Training Opportunities to Further Personal and Professional Growth
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Director
