Director of Revenue Cycle

Optimus Health Care, Inc.•Stratford, CT

4d•Onsite

About The Position

Optimus Health Care, the largest provider of primary health care services in Fairfield County, is seeking an experienced Director of Revenue Cycle to join their team onsite in Stratford. This role is responsible for the strategic, operational, financial, and personnel leadership of the organization's end-to-end revenue cycle, including billing, claims management, denial management, reimbursement, accounts receivable, cash posting, and collections. The Director ensures timely and accurate reimbursement, regulatory compliance, optimized cash flow, and continuous improvement of revenue cycle performance. As a senior member of the Finance leadership team, this position partners closely with executive leadership, Operations, Clinical leadership, and Information Systems to align revenue cycle strategy with organizational priorities, financial sustainability, and patient-centered care. The role provides enterprise oversight of revenue cycle functions, drives data-informed decision making, and ensures strong internal controls across all billing and collection activities.

Requirements

Minimum of eight (8) years of progressively responsible revenue cycle or healthcare financial management experience
At least five (5) years in a senior revenue cycle leadership role
Bachelor’s degree in business, Healthcare Administration, or a related field required.

Nice To Haves

Master’s degree preferred.
Experience in an FQHC, large medical group, hospital system, or complex healthcare environment preferred.
Bilingual English/Spanish preferred.

Responsibilities

Provide strategic and operational leadership for all billing, claims management, reimbursement, denial management, accounts receivable, cash posting, and collection activities.
Establish, monitor, and continuously improve revenue cycle performance metrics, including days in accounts receivable, denial rates, net collection rate, cash collections, and write-offs.
Develop, implement, and monitor revenue cycle goals, benchmarks, and key performance indicators using internal and external benchmarking data.
Analyze revenue cycle data to identify trends, root causes, risks, and opportunities; develop and execute corrective action and performance improvement plans.
Oversee denial prevention and management strategies, including root cause analysis, appeals processes, and payer trend monitoring.
Ensure accurate charge capture, coding, billing, and reimbursement processes through collaboration with Clinical, Operations, and Compliance leadership.
Ensure compliance with all applicable federal, state, payer, and HRSA/FQHC regulations and requirements.
Lead revenue cycle audits, both internal and external, and implement corrective action plans as needed.
Develop, maintain, and enforce standardized revenue cycle policies, procedures, and internal controls.
Oversee management of delinquent accounts, adjustments, refunds, and write-offs in accordance with organizational policy and regulatory requirements.
Partner with Operations and Clinical leadership to support timely encounter closure and efficient billing workflows.
Oversee revenue cycle reporting and dashboards for leadership, including financial performance, trends, and budget variances.
Lead system optimization and effective utilization of Epic and other revenue cycle technologies.
Drive continuous improvement initiatives to enhance efficiency, accuracy, and financial performance across revenue cycle operations.
Provide leadership, coaching, and performance management for revenue cycle management staff and teams.
Provide direct oversite of Financial Counselors ensuring they maintain quality, customer service, and productivity standards in addition to enrolling all eligible patients into the Optimus Financial Assistance program, state, or ACHT exchange plans consistent with regulatory requirements.
Work with Practice Managers to ensure the front office registrars are trained in using EPIC to record patient data, including eligibility verification and insurance authorization to ensure accurate billing.
Manage complex interdepartmental and interdisciplinary relationships to ensure collaboration and effective operations.
Remain current on industry trends, payer changes, reimbursement methodologies, and regulatory updates impacting revenue cycle operations.
Represent the Revenue Cycle function on internal and external committees, as appropriate.
Incorporate Optimus Health Care’s mission, vision, and values into all revenue cycle initiatives and activities.
Perform other duties as assigned.