Director of Revenue Cycle Management

Revive Bhs•Severna Park, MD

1d•Hybrid

About The Position

Revive BHS is seeking an experienced Director of Revenue Cycle Management to lead revenue cycle operations for a growing portfolio of behavioral health clients throughout Maryland, including substance use disorder treatment programs, Outpatient Mental Health Centers (OMHCs), and other community-based providers. This hands-on leadership role oversees client accounts and Revive’s billing team, establishes and monitors billing workflows, identifies reimbursement issues, and helps ensure clients collect the revenue to which they are entitled. The role requires managing multiple organizations, payer mixes, EHR systems, and levels of care simultaneously. The Director leads the full revenue cycle, from benefits verification and authorization through claim submission, payment posting, reconciliation, denial management, appeals, collections, patient responsibility, statements, and reporting. The position supervises and develops RCM staff, monitors account performance, establishes corrective actions, supports client onboarding and billing-system transitions, and communicates performance and recommendations to Revive and client leadership. The Director also ensures billing practices comply with applicable payer rules and regulations and identifies opportunities to improve efficiency and collections through workflows and technology. The role must be local to Anne Arundel County, Maryland, for in-person attendance one to two days per week. Flexible work-from-home options are available. Compensation is $90,000–$110,000 per year.

Requirements

At least 5 years of healthcare revenue cycle management experience, including significant leadership or management responsibility.
Direct experience with Maryland behavioral health billing.
Strong working knowledge of Maryland Medicaid/PBHS and Carelon Behavioral Health.
Experience billing for OMHC and/or substance use disorder treatment services.
Thorough understanding of behavioral health authorizations, eligibility verification, claims submission, payment posting, denials, appeals, collections, and A/R management.
Experience managing multiple client accounts, locations, programs, or billing entities at the same time.
Ability to analyze A/R and reimbursement data and translate findings into operational improvements.
Experience supervising and developing billing teams.
Strong understanding of CPT, HCPCS, ICD-10, modifiers, payer-specific billing requirements, and behavioral health reimbursement methodologies.
Experience with behavioral health EHRs, clearinghouses, payer portals, and electronic claims and remittance systems.
Strong Excel or Google Sheets and reporting skills.
Excellent written and verbal communication skills.
Highly organized and able to manage competing priorities and deadlines.
Strong problem-solving skills and ability to independently research and resolve complex payer and reimbursement issues.
Must be local to Anne Arundel County, Maryland, to attend in person one to two days per week.

Nice To Haves

Experience with multiple Maryland behavioral health levels of care, including OMHC, IOP, PHP, outpatient SUD, residential SUD, PRP, and other community-based services.
Experience with Carelon, Medicaid EVS, Availity, commercial payer portals, and Maryland-specific behavioral health authorization processes.
Experience implementing or transitioning EHR and billing systems.
Experience managing RCM operations for a third-party billing company, consulting organization, or multi-site behavioral health organization.
CPC, CPB, CRCR, or another relevant billing/revenue cycle certification; preferred but not required.
Bachelor’s degree in healthcare administration, business, finance, or a related field; equivalent relevant experience will be considered.

Responsibilities

Oversee day-to-day revenue cycle operations for a portfolio of Maryland behavioral health clients, including SUD treatment programs, OMHCs, and other providers.
Manage the full revenue cycle, including benefits and eligibility verification, authorizations, claim creation and submission, payment posting, reconciliation, denials, appeals, collections, patient responsibility, and statements.
Lead and supervise billing managers, billing specialists, authorization/VOB staff, and other RCM team members.
Monitor billing activity and ensure claims are accurate and submitted on time.
Oversee Maryland Medicaid/PBHS billing through Carelon Behavioral Health, as well as commercial insurance and other applicable payers.
Monitor accounts receivable and establish timely follow-up processes for unpaid, underpaid, rejected, and denied claims.
Review aging reports and identify payer, provider, authorization, coding, documentation, or operational trends that affect collections.
Develop corrective action plans for elevated denials, aging A/R, authorization issues, and reimbursement problems.
Monitor reimbursement against fee schedules and contracted rates and identify underpayments.
Oversee denial management and payer appeals, escalating recurring or systemic payer issues.
Establish and monitor account-level KPIs, including clean claim rate, denial rate, days in A/R, aging by bucket, collection rate, authorization-related denials, outstanding A/R, and monthly collections.
Provide regular revenue cycle reporting to Revive and client leadership; participate in client meetings and communicate performance, problems, corrective actions, and recommendations.
Develop and implement standardized billing workflows, policies, procedures, internal controls, and account-specific processes.
Assist with onboarding RCM clients, including EHR and clearinghouse setup, payer configuration, billing matrices, fee schedules, workflows, reporting, and transitions from other billing vendors or internal teams.
Collaborate with credentialing and consulting teams when enrollment, licensing, credentialing, or operational issues affect reimbursement.
Ensure billing practices comply with Maryland Medicaid, Carelon, Medicare when applicable, commercial payer requirements, HIPAA, and applicable federal and state regulations.
Stay current on Maryland behavioral health reimbursement and billing requirements, authorization requirements, payer policies, fee schedules, and coding guidance.
Recruit, train, supervise, and evaluate RCM staff as the department grows.
Identify opportunities for automation, workflow improvement, and technology use to increase efficiency and collections.
Serve as the primary internal escalation point for complex billing, reimbursement, payer, and revenue cycle issues.