Director of Revenue Cycle

Arrowhead OrthopaedicsRedlands, CA
113d

About The Position

The Director of Revenue Cycle is responsible for overseeing all aspects of the revenue cycle process within the organization, including patient access, billing, collections, coding, reimbursement, and compliance. This position ensures that revenue cycle operations align with federal and state regulations, payer requirements, and organizational financial goals. The Director will lead teams across patient financial services, health information management, and billing functions to optimize efficiency, reduce denials, and maximize revenue capture. This role requires a highly strategic leader with expertise in healthcare finance, regulatory compliance, payer relations, and revenue cycle technology. The Director must balance operational leadership with regulatory knowledge (e.g., CMS, HIPAA, Medi-Cal, Medicare, and commercial payers), while maintaining strong communication with clinical and administrative departments.

Requirements

  • Bachelor’s degree in Healthcare Administration, Finance, Business.
  • 7–10 years of progressive experience in healthcare revenue cycle management, with at least 3 years in a senior leadership role.
  • Strong knowledge of Medi-Cal, Medicare, commercial insurance, and California-specific payer regulations.
  • Expertise in medical billing, coding, compliance, and reimbursement methodologies.
  • Experience with EHR and revenue cycle management systems (e.g., Epic, Cerner, Allscripts).
  • Advanced knowledge of revenue cycle processes, payer regulations, and healthcare reimbursement.
  • Strong financial and analytical skills, with ability to interpret complex data.
  • Excellent leadership, communication, and conflict resolution skills.
  • Ability to work collaboratively with physicians, administrators, and external stakeholders.
  • Strong problem-solving skills with an emphasis on process improvement.

Nice To Haves

  • Master’s degree preferred.

Responsibilities

  • Develop and implement revenue cycle strategies to ensure timely and accurate billing, collections, and reimbursement.
  • Lead, mentor, and evaluate teams in patient access, billing, coding, and collections.
  • Collaborate with clinical and administrative leaders to improve workflows affecting reimbursement.
  • Monitor key performance indicators (KPIs) such as days in accounts receivable (AR), denial rates, collection efficiency, and cash flow.
  • Develop revenue cycle dashboards and reports for executive leadership.
  • Identify areas for process improvement and implement corrective actions.
  • Ensure adherence to state and federal regulations (California Department of Health Care Services, Medi-Cal, Medicare, HIPAA).
  • Maintain compliance with payer contracts, coding regulations, and billing requirements.
  • Lead internal audits and respond to payer audits or inquiries.
  • Oversee charge capture, coding accuracy, and documentation improvement initiatives.
  • Implement and optimize revenue cycle technologies, including EHR and billing systems.
  • Partner with IT and compliance departments to strengthen revenue integrity.
  • Serve as primary liaison between the organization and third-party payers.
  • Develop and maintain effective communication with patients regarding financial responsibilities.
  • Educate clinical and administrative staff on revenue cycle best practices.

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What This Job Offers

Career Level

Senior

Education Level

Bachelor's degree

Number of Employees

251-500 employees

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