Revenue Cycle Director

Vocational Instruction Project•New York, NY

About The Position

The Revenue Cycle Director oversees all billing, collections, and reimbursement operations to ensure accurate, timely, and compliant revenue capture across VIP’s health care programs. This leader manages the full revenue cycle team, ensures adherence to regulatory and payer requirements, and drives continuous improvement through data-driven decision-making. A key expectation of this role is the ability to leverage AI-powered tools, analytics platforms, and automated dashboards to enhance billing accuracy, accelerate collections, and provide leadership with real-time financial insights

Requirements

Bachelor’s degree required. Masters preferred
Minimum 5 years of supervisory experience in a health care billing environment.
Prior billing experience in behavioral health required.
Demonstrated billing compliance experience.
Proficiency with CPT, ICD-9/ICD-10, and coding systems.
Experience with electronic health records (EHR/EMR) systems.
Strong communication, administrative, organizational, and interpersonal skills.
Computer literacy and familiarity with billing systems.
Experience with Medicaid, Medicare, and private insurance billing.
Skills in medical billing, collections, EHR systems, insurance authorizations, and payer relations.

Nice To Haves

Experience using AI-driven analytics, reporting tools, or automated dashboards.
Familiarity with Power BI, Tableau, or similar visualization platforms.
Knowledge of AI-assisted claims scrubbing or predictive denial management tools.

Responsibilities

Direct denial management and appeals processes, implementing root-cause analysis to reduce future claim rejections.
Serve as a key liaison with VIP’s billing consultant, external vendors, and insurance payers to address operational issues and strengthen financial outcomes.
Manage and supervise daily operations of the billing, collections, and revenue cycle team.
Monitor key performance indicators (KPIs) such as days in accounts receivable, denial rates, net collection rates, and clean claim rates to ensure departmental effectiveness and financial stability.
Ensure compliance with federal, state, and payer regulations including billing standards, documentation requirements, and reimbursement policies.
Maintain up-to-date knowledge of CPT, ICD-9/ICD-10, commercial insurance, Medicaid and Medicare rules, and health care billing standards.
Oversee payer contract management, proactively establish new payer agreements and collaborate with finance and executive leadership to maximize reimbursement and resolve payer issues.
Negotiate service rates and resolve payment or billing issues with insurance companies.
Ensure concrete understanding of contractual obligations and implement strategies to comply with contractual obligations.
Ensure patients with non-participating insurance companies are informed and redirected
Monitor regulatory changes (OASAS, Medicaid, etc.) and implement required updates in billing systems.
Develop and maintain written procedures for fee establishment, billing, and collections.
Coordinate internal and external audits related to billing, coding, and revenue cycle processes and implement corrective action plans when necessary. Lead initiatives to improve revenue integrity, including charge capture accuracy, documentation compliance, and coding quality.
Monitor key performance indicators (KPIs) such as days in accounts receivable, denial rates, net collection rates, and clean claim rates to ensure departmental effectiveness and financial stability.
Oversee daily insurance verification and benefit checks.
Ensure timely authorization/pre-certification for new and ongoing treatment services.
Track authorized visits and distribute treatment plan requirements to counseling staff.
Notify staff of changes in Medicaid or insurance status.
Collaborate with clinical, compliance, and finance teams to align operational workflows with reimbursement requirements and regulatory standards.
Perform and oversee financial transactions including verifying, classifying, computing, posting, and reconciling accounts receivable.
Match billing accounts with the A/R ledger to ensure accurate payment posting.
Prepare and present regular reports on accounts status, collections, denials, and revenue trends.
Manage revenue cycle technology platforms including electronic health record (EHR), practice management systems, and billing software to enhance efficiency and reporting capabilities.
Use AI-powered tools to automate billing quality checks, identify anomalies, and flag potential denials.
Develop smart dashboards that visualize KPIs such as days in A/R, denial rates, authorization timeliness, and collection efficiency.
Build predictive models to forecast revenue, identify bottlenecks, and optimize workflow performance.
Train staff on using AI-assisted tools for eligibility verification, claims scrubbing, and documentation accuracy.
Integrate AI insights into monthly leadership reports and strategic planning.
Develop and mentor revenue cycle staff, establishing performance goals, training programs, and professional development initiatives. Collaborate with clinical, administrative, and IT teams to ensure accurate documentation and smooth billing operations.
Promote a culture of accountability, continuous improvement, and data-driven decision-making.