Director of Revenue Cycle Management: Hybrid- Must be local- 7387

CHR Career • Windsor, CT

11d • Hybrid

About The Position

The Director of Revenue Cycle Management leads and continuously improves end-to-end revenue cycle operations, including patient registration, eligibility verification, coding, billing, claims submission, payment posting, denials management, and collections. The role develops and maintains compliant policies, procedures, and workflows to maximize reimbursement and minimize errors, while partnering with clinical, operations, and front-office leadership on effective revenue cycle workflows and patient financial processes. The director oversees contract performance and reimbursement optimization across Medicaid, Medicare, commercial insurers, and other third-party payers.

The director monitors performance using KPIs, dashboards, and trend analysis; communicates results and corrective actions to the CFO and senior leadership; and develops regular performance reports for finance leadership and the Board as needed. The role identifies and resolves denials, delayed payments, and underpayments, and promotes continuous improvement, efficiency, and service orientation.

The position ensures compliance with applicable federal, state, and local healthcare billing regulations and adapts processes to payer-policy, regulatory, and behavioral-health billing changes. It establishes systems, controls, and audits to support accuracy and compliance. The director negotiates, reviews, and manages payer contracts; maintains a centralized contract repository and tracking system; analyzes contract performance; works with legal counsel and senior leadership on contractual risks and disputes; maintains payer fee schedules; and serves as the primary contact for payer contract inquiries and escalations.

The director recruits, develops, and retains a high-performing revenue cycle team, setting goals and providing training, mentorship, and accountability. The role also manages vendor relationships, including billing services, clearinghouses, and patient payment platforms. It leverages EHR and practice management systems, identifies technology enhancements and integrations—including AI-assisted coding tools—and collaborates with IT and operations on data integrity and system functionality.

This is a full-time, 40-hour-per-week hybrid position in the Finance Department in Windsor, Connecticut, with at least two days per week in the office. The stated schedule is Monday through Friday, 9:00 a.m. to 5:00 p.m.

Requirements

• Bachelor's degree in Business, Finance, Accounting, Health Administration, or a related field.
• At least 10 years of progressive revenue cycle experience in a healthcare or behavioral health setting.
• At least 3 years of leadership or supervisory experience managing revenue cycle staff.
• Demonstrated expertise in Medicaid and Medicare billing.
• Proven experience negotiating and managing payer contracts in a healthcare environment.
• Deep understanding of end-to-end revenue cycle functions and healthcare reimbursement models.
• Strong analytical and data-driven skills, including use of reporting tools and dashboards to drive performance.
• Excellent communication, organizational, and stakeholder-management skills.
• Proficiency with EHR and practice management platforms.
• Working knowledge of ICD-10, CPT, and HCPCS coding systems.
• Strong problem-solving skills and ability to manage competing priorities in a complex environment.

Nice To Haves

• Master's degree (MBA, MHA, or equivalent).
• Experience in a nonprofit or community-based healthcare organization.
• Behavioral health billing experience.
• Experience with Qualifacts Credible.
• Experience with contract management software or payer contract tracking systems.
• Certified Revenue Cycle Professional (CRCP), Certified Professional Biller (CPB), or equivalent credential.
• HFMA membership or Certified Healthcare Financial Professional (CHFP) certification.

Responsibilities

• Lead and continuously improve end-to-end revenue cycle processes, including registration, eligibility verification, coding, billing, claims, payment posting, denials, and collections.
• Develop, implement, and maintain compliant revenue cycle policies, procedures, and workflows.
• Partner with clinical, operations, and front-office leaders to improve front-end workflows and patient financial processes.
• Oversee payer contract performance and reimbursement optimization.
• Monitor revenue cycle performance through KPIs, dashboards, and trend analysis; communicate findings and corrective actions to leadership.
• Identify, prevent, and resolve denials, delayed payments, and underpayments through process improvements.
• Prepare regular revenue cycle performance reports for finance leadership and the Board as needed.
• Ensure compliance with applicable regulations and adapt processes to payer-policy and regulatory changes.
• Implement systems, internal controls, and audit processes supporting accuracy, productivity, and compliance.
• Negotiate, review, and manage payer contracts and maintain a centralized contract repository and tracking system.
• Monitor contract milestones, renewals, rate changes, termination clauses, performance, and reimbursement variances.
• Collaborate with legal counsel and senior leadership to assess contractual risk, resolve disputes, and ensure contract compliance.
• Develop and maintain payer fee schedules and update billing systems when contracts change.
• Serve as the primary contact for payer contract inquiries and escalations and build relationships with payer representatives.
• Recruit, develop, and retain revenue cycle staff; provide goals, training, mentorship, and performance accountability.
• Foster a collaborative team culture emphasizing accuracy, responsiveness, and continuous learning.
• Manage and evaluate vendors, including billing services, clearinghouses, and patient payment platforms.
• Use EHR and practice management systems to optimize revenue cycle workflows and reporting.
• Identify and implement technology enhancements or integrations, including AI-assisted coding tools.
• Collaborate with IT and operational teams to ensure revenue cycle data integrity and system functionality.

Benefits

• Health insurance.
• Paid time off, including birthday time off.
• Employer contributions to a 403(b) retirement plan.
• Competitive insurance premiums and discounts on pet, home, and auto insurance.
• Tuition reimbursement and professional development programs, including tuition discounts at local colleges and universities.
• Career development opportunities and a free training curriculum.
• Clinical supervision and/or mentoring at several programs.
• Wellness program with an annual wellness stipend.
• Free premium Calm app subscription.
• Six free confidential counseling sessions through the Employee Assistance Program.
• Employee appreciation events, contests, lunch-and-learns, and employee-led resource groups.

What This Job Offers

• Job Type: Full-time
• Career Level: Director