Director of Revenue Cycle

MetroEHS Pediatric Therapy•Plymouth, MI

8h•Onsite

About The Position

The Director of Revenue Cycle oversees and leads all aspects of the revenue cycle for our collaborative pediatric therapy program. This role is responsible for ensuring the financial health of the program by optimizing front-end and back-end billing operations, enhancing revenue integrity, and ensuring compliance with payer requirements. The Director of Revenue Cycle partners with Clinical, Administrative, Operations, Finance, and IT leadership to improve workflow efficiency, reduce denials, accelerate cash flow, and maintain high levels of patient and provider satisfaction. This position requires strong expertise in medical billing , collections , payer contracting , and compliance —particularly in the context of pediatric therapy including SLP, OT, PT, and ABA services.

Requirements

Minimum of 5–7 years of progressive leadership experience in healthcare revenue cycle management.
Ability to troubleshoot payer issues and resolve them
Demonstrated knowledge of payer requirements and compliance standards related to billing and claims submissions.
Strong understanding of CPT coding, billing guidelines, and reimbursement protocols.
Knowledge of payer requirements for billing and claims submissions.
Proven expertise in managing end-to-end revenue cycle workflows in multi-location programs.
Strong analytical and problem-solving skills; proficiency in Excel and revenue cycle software and EHR systems. (Raintree preferred though not required).

Nice To Haves

Bachelor’s degree in Healthcare Administration, Finance, Business, or related field.
Certified Professional Coder (CPC) or equivalent certification.
Deep understanding of pediatric therapy billing, coding and payor rules including ABA, SLP, OT, PT and MH.
Ability to review and negotiate payer contracts to maximize reimbursement while managing administrative burden.

Responsibilities

Lead and develop strategies to optimize revenue cycle performance across all service lines (ABA, SLP, OT, PT and MH).
Establish and monitor KPIs related to billing, collections, AR days, denial rates, and charge lag.
Oversee revenue cycle analytics and proactively identify trends, gaps, and opportunities for improvement, as well as perform revenue forecasting, and supportive financial planning.
Develop and implement policies and procedures for billing, coding, invoicing, collections, and account reconciliation to ensure compliance with organizational standards and regulatory requirements.
Ensure clean claim submission, timely payment posting, and effective denial management.
Implement policies and controls to maintain compliance with Medicaid, commercial payers, all third-party payers and specialty-specific regulations.
Partner with front desk and clinical teams to ensure complete and accurate patient registration and documentation.
Resolve escalated patient complaints and complex staffing challenges or issues.
Monitor regulatory updates (e.g., CMS, HIPAA) to ensure compliant billing practices.
Oversee proper coding and documentation practices in collaboration with coding and clinical staff.
Recruit, train, and evaluate performance of revenue cycle team members to ensure high performance and adherence to industry best practices.
Foster a culture of accountability, efficiency, and continuous improvement.
Serve as a key resource and strategic advisor to executive leadership on financial operations and revenue opportunities.