Director of Revenue Cycle Management

Winfield, Kansas•Winfield, KS

About The Position

The Director of Revenue Cycle provides strategic leadership and operational oversight of William Newton Hospital’s revenue cycle, including patient access, billing, coding, claims, denials management, accounts receivable, and payer relations. The role is responsible for achieving revenue goals established through the organization’s planning and goal-setting processes and approved by the CFO. It develops strategies to maximize third-party revenue, improve collections, reduce denials, and ensure compliance across payer types, including Medicaid, Medicare, commercial insurance, and VA. The Director reports to the Chief Financial Officer and builds a sustainable team structure with cross-training and sufficient depth to ensure continuity of operations. The Director oversees revenue cycle performance across service lines and billing platforms; develops workflows, staffing plans, and revenue models for new or expanding services; monitors key performance indicators; and recommends investments, technology enhancements, and staffing adjustments. The role oversees patient access, financial counseling, coverage enrollment assistance, coding quality, charge capture, payer relations, provider enrollment, and revenue cycle systems. It collaborates with executive, clinical, IT, health information management, and other department leaders, and represents WNH on applicable technology advisory committees. The Director recruits, develops, and retains staff; ensures adequate staffing; supports cross-training, documentation, and succession planning; and conducts evaluations and coaching. The role ensures compliance with applicable federal, state, and tribal requirements, partners with the Quality Director on billing, coding, and documentation compliance activities, and prepares reports and recommendations for the CFO and executive leadership. It also promotes cultural sensitivity and performs other related duties as assigned. The position directs and coordinates patient accounting to support accurate, timely-paid bills; monitors interactions with collection agencies, insurers, Admissions, Medical Records, Information Systems, patients, and physicians; coordinates corrective action; and supports effective use of departmental computer systems. It works with auditors, maintains awareness of reimbursement regulations and contractual arrangements, plans staffing to meet workload, coordinates Patient Accounts with Accounts Receivable, Registration, HIM, and Nursing, maintains departmental records and reports, and improves processes through effective use of technology. The Director is expected to support organizational and departmental goals, round on staff, and send thank-you notes monthly. The work environment has an average noise level. The role regularly uses hands and arms and requires talking or hearing; standing and/or sitting are frequent, while walking, sitting, climbing, or balancing are occasional. The position requires frequently lifting or moving up to 10 pounds and occasionally up to 25 pounds. Occasional participation in meetings outside standard office hours is required. Reasonable accommodations may be made for individuals with disabilities. WNH expects employees to practice its Standards of Behavior: Integrity, Patient-Centeredness, Accountability, Compassion, and Excellence.

Requirements

Bachelor’s degree in healthcare administration, business administration, health information management, finance, or a related field; relevant experience, education, and training may substitute on a year-for-year basis.
Five years of progressively responsible experience in healthcare revenue cycle operations, including demonstrated revenue growth initiatives such as denial reduction, payer strategy, coding optimization, or new service line billing.
Two years of supervisory experience managing teams or functional areas, or demonstrated equivalent leadership responsibility.
Knowledge of revenue cycle processes from patient registration through collections, including charge capture, coding, claim submission, payment posting, denial management, and accounts receivable follow-up.
Knowledge of multi-payer billing requirements, including Medicaid, Medicare, commercial insurance, and VA.
Knowledge of medical terminology and CPT, ICD-10-CM, CDT, and HCPCS coding systems sufficient to oversee coding operations and evaluate quality.
Knowledge of HIPAA privacy and security requirements as applied to revenue cycle operations.
Effective oral and written communication skills.
Ability to operate personal computers and a variety of software, including healthcare billing platforms, electronic health records, and data analytics tools.
Skills in strategic planning, financial analysis, and turning revenue data into actionable improvement plans.
Ability to lead and develop teams, including supervising supervisory staff and managing contracted or remote resources.
Ability to influence change and build collaborative relationships across departments and with external partners without direct authority.
Ability to establish and maintain cooperative working relationships with management, coworkers, and outside contacts.
Ability to maintain strict confidentiality and comply with applicable federal laws and WNH policy, including HIPAA.
Ability to learn and apply program and agency operating policies and procedures.
Ability to manage concurrent priorities and tasks and meet deadlines, working independently and with teams.
Meet the stated physical demands, with reasonable accommodations available: regular hand use, reaching, and talking or hearing; frequent standing and/or sitting; occasional walking, sitting, climbing, or balancing; frequent lifting or moving up to 10 pounds and occasional lifting or moving up to 25 pounds.
Occasional participation in meetings outside standard office hours is required.

Nice To Haves

Master’s degree in healthcare administration (MHA), business administration (MBA), or a related field.
Ten or more years of healthcare revenue cycle experience with progressive leadership responsibility.
Experience operating across multiple billing and EHR platforms simultaneously.
Professional certification such as CPC, CPB, CRCR, CHFP (Certified Healthcare Financial Professional), or equivalent.
Experience in RHCs.
Strong commitment to multidisciplinary teamwork.

Responsibilities

Develop and execute revenue cycle strategies aligned with organizational revenue goals approved by the CFO, working with executive leadership to achieve financial targets.
Monitor payer mix trends, identify revenue impacts, implement corrective strategies, and help ensure patients are enrolled in available coverage programs.
Develop revenue models, billing workflows, and staffing plans for new and expanding service lines before launch.
Oversee end-to-end revenue cycle performance across billing platforms and service lines, ensuring timely claim submission, accurate coding, and maximum reimbursement.
Recommend revenue cycle investments, technology enhancements, and staffing adjustments to the CFO and CEO, including budget justification tied to projected revenue impact.
Oversee denial management, review trends, perform root-cause analysis, and implement interventions to reduce denials and improve recovery.
Establish and enforce accounts receivable aging thresholds, write-off policies, escalation protocols, and KPI policy frameworks where needed.
Monitor net collection rates, days in accounts receivable, clean claim rates, and other KPIs by payer and service line; report performance and variances to the CFO and executive leadership.
Set standards for patient access, including registration accuracy, insurance verification, eligibility confirmation, prior authorization, and point-of-service collections.
Coordinate with clinical program leadership to align patient access processes with billing requirements across service lines and locations.
Oversee patient financial counseling and coverage enrollment assistance, including coordination around insurance programs, tribal sponsorship, and financial assistance.
Oversee coding operations for accuracy, compliance, and timeliness across service lines and coding systems.
Establish coding quality assurance processes, including audits, provider education, and feedback to improve documentation and reduce coding-related denials.
Monitor charge capture workflows and chart closure timelines; work with clinical leadership and health information management to reduce DNFB and coding lag.
Serve as WNH’s subject matter authority on payer requirements, reimbursement methodologies, and contract terms; prepare analysis and recommendations for payer contract negotiations.
Monitor fee schedule updates, regulatory changes, and payer policy shifts affecting reimbursement, and communicate impacts to staff and executive leadership.
Monitor provider enrollment status across active payers with credentialing staff; enforce enrollment service-level agreements and escalate delays affecting billing readiness.
Oversee revenue cycle operations across billing and practice management platforms to support workflow efficiency, data integrity, and interoperability.
Collaborate with IT, clinical leadership, and external partners to evaluate, select, design, implement, and optimize EHR and billing systems.
Document and escalate system issues affecting revenue cycle operations; represent revenue cycle requirements in technology governance and partnership forums.
Represent WNH on applicable advisory committees related to health information systems and technology partnerships.
Recruit, develop, and retain a high-performing revenue cycle team; directly supervise specialized staff and ensure adequate staffing levels.
Build team capacity through cross-training, process documentation, and succession planning.
Foster continuous improvement, accountability, and professional development; conduct performance evaluations, coach and mentor staff, and address performance issues under WNH policies.
Ensure revenue cycle operations comply with applicable federal, state, and tribal regulations, including HIPAA, CMS guidelines, IHS, and confidentiality requirements for specialized programs.
Partner with the Quality Director on compliance activities related to billing, coding, and documentation; primary compliance program authority rests elsewhere.
Prepare and present revenue cycle reports, metrics, trend analysis, and strategic recommendations to the CFO and executive leadership as requested.
Promote cultural sensitivity in revenue cycle interactions and respect patients’ needs, values, and cultural practices.
Direct and coordinate patient accounting to produce accurate bills that are paid in a timely manner.
Monitor activities involving collection agencies, insurance companies, Admissions, Medical Records, Information Systems, patients, and physicians; coordinate operations and recommend corrective action as appropriate.
Use and understand departmental computer systems to realize their potential and answer staff questions about system mechanics.
Use tact and diplomacy when setting patient accounts and responding to physician requests to discount patient bills, following facility guidelines.
Work cooperatively and responsively with auditors locating patient bills.
Maintain current awareness of third-party reimbursement regulations and HMO and PPO contractual arrangements.
Forecast personnel needs based on projected workload, maximize human-resource utilization, and organize staffing to respond to patient and customer needs.
Accumulate statistical information and report it accurately and promptly to the CFO.
Coordinate Patient Accounts routinely with Accounts Receivable, Registration, HIM, and Nursing.
Maintain required departmental records and improve work methods, including reducing paper processes through greater use of computer technology and activity consolidation.
Develop efficient departmental methods and systems, reduce unnecessary time and effort, and institute changes to techniques and procedures as needed.
Work toward organizational and departmental goals, round on staff, and send thank-you notes monthly.
Perform other related duties as assigned.