Director of Revenue Cycle Management

OMS MEDICAL BILLING LLC•Addison, TX

170d•Onsite

About The Position

OrthoMed Anesthesia is seeking a strategic, hands-on Director of Revenue Cycle Management (RCM) to lead and optimize all aspects of anesthesia billing operations. This critical leadership role is responsible for the full RCM cycle, with a specialized focus on anesthesia-specific complexities such as concurrency, medical direction, modifier usage, and payer compliance. The Director will collaborate across departments—including clinical, IT, and executive leadership—to ensure financial accuracy, regulatory compliance, and operational efficiency across a growing network of providers and facilities.

Requirements

Bachelor’s degree in Healthcare Administration, Finance, or equivalent professional experience
Minimum 5 years of progressive RCM leadership, with a strong background in physician-based billing
Deep understanding of CPT coding, ASA modifiers, concurrency rules, time documentation, and payer policies
Knowledge of federal compliance standards, including CMS regulations
Demonstrated experience designing and optimizing payment tracking and patient accounting workflows, including payment posting reconciliation, contractual adjustment controls, patient balance resolution, and financial clearance processes
Working knowledge of or hands-on experience with agentic AI solutions for post-bill operations and automated appeals platforms, including AI-driven A/R work queues, intelligent denial routing, and automated payer correspondence
Demonstrated success in team leadership, change management, and driving performance improvements
Strong communication and analytical skills; experience with business intelligence (BI) tools is a plus

Nice To Haves

AAPC, HFMA, or CRCM certification
Experience with anesthesia-specific platforms (e.g., KAM, MedSuite, PPM, or PHI)
Familiarity with Medicare, Medicaid, and major commercial payer billing guidelines
Understanding of No Surprises Act (NSA), Independent Dispute Resolution (IDR), and Texas Department of Insurance (TDI) regulations
Operational experience managing NSA/IDR submissions, including eligibility determinations, offer calculations, certified IDR entity coordination, and jurisdictional compliance across federal and state surprise billing frameworks
Experience implementing or overseeing automated appeals management platforms and agentic AI tools integrated with anesthesia billing systems for denial resolution, payer correspondence, and post-bill workflow orchestration

Responsibilities

Develop and implement RCM strategies to reduce days in A/R, improve cash flow, and minimize denials
Oversee all components of the RCM process: billing, coding, charge posting, appeals, and patient financial services
Monitor key performance indicators (KPIs) and produce actionable reports to inform decision-making
Direct accounts receivable inventory management strategies, including prioritization frameworks, aging bucket oversight, and productivity benchmarks to maximize collections velocity and minimize revenue leakage
Oversee payer payment variance analysis, ensuring contractual underpayments are identified, documented, and recovered through systematic reconciliation of expected versus actual reimbursement across all payer contracts
Lead comprehensive denial management and claims appeals programs, establishing root-cause analysis workflows, appeal letter standards, and escalation paths to reduce denial rates and maximize overturn success
Manage charge correction processes and systematic follow-up on “No Activity” claims, ensuring timely resolution of suspended, rejected, or unworked accounts before filing deadlines are compromised
Drive revenue assurance initiatives and maintain expert-level knowledge of No Surprises Act (NSA) compliance, Independent Dispute Resolution (IDR) eligibility and jurisdictional requirements, and applicable state surprise billing regulations to protect net revenue
Leverage technology solutions to enhance post-bill efficiency, including agentic AI tools for intelligent A/R prioritization and workflow automation, and automated appeals platforms to accelerate denial resolution and reduce manual intervention
Lead, mentor, and scale a team of onshore and offshore RCM personnel
Collaborate with credentialing, compliance, and IT teams to optimize workflows and integrations
Serve as the internal expert on anesthesia billing regulations and payer-specific requirements
Identify revenue trends and proactively address compliance risks
Support internal audits, payer negotiations, and staff training initiatives
Perform additional duties as needed in alignment with OrthoMed Anesthesia’s mission