Revenue Cycle Operations Lead - Hybrid in Colorado

Vail-Summit Orthopaedics & Neurosurgey•Edwards, CO

5d•Hybrid

About The Position

The Revenue Cycle Operations Lead is a hands-on role responsible for overseeing VSON’s revenue cycle workflows, coordinating with external billing partners, and ensuring accurate and efficient execution of all internal revenue cycle responsibilities. This role is critical in a hybrid model where select functions are supported by third-party vendors while core ownership, oversight, and accountability remain within VSON. The position requires strong technical expertise, operational ownership, and the ability to identify and resolve gaps in processes while maintaining financial accuracy and continuity across all revenue cycle functions. This is not a traditional “manager-only” role - this individual will actively engage in workflows, own outcomes, and serve as the internal subject matter expert and primary point of accountability for revenue cycle performance.

Requirements

Strong, hands-on experience in medical billing and revenue cycle operations (orthopedic or specialty practice preferred)
Experience working with external billing vendors or hybrid RCM models
Deep understanding of claims lifecycle, denials, coding coordination, and payer requirements
Experience with financial reconciliation, reporting, and revenue cycle controls
Ability to analyze data, identify trends, and drive process improvement
Strong communication, organization, and problem-solving skills
Experience with eClinicalWorks (eCW) and clearinghouse systems preferred
Strong analytical, reporting, and problem-solving skills
Leadership experience with ability to drive change and accountability
Associates degree, preferably in business administration or related field; Bachelor degree preferred. 7+ years of medical insurance/healthcare revenue cycle experience will be considered in lieu of the degree.
Minimum of 3 years medical insurance/healthcare billing and collections experience in a medical practice health system, with a deep understanding of medical billing rules and regulations. Orthopaedic preferred.
Two years supervisory or management experience required
Outstanding communication and leadership skills

Nice To Haves

Orthopedic or specialty practice experience preferred
Orthopaedic experience preferred

Responsibilities

Maintain full visibility into revenue cycle performance including charge capture, coding coordination, claims submission, denials, and collections
Monitor and analyze key performance indicators (AR days, denial rates, lag times, net collections)
Identify trends, risks, and revenue leakage and implement corrective actions
Ensure work queues (internal and vendor) are actively managed and resolved timely
Serve as the primary operational liaison for external billing partners (e.g., Synergen, clearinghouse, workflow tools)
Assign, monitor, and follow up on vendor work to ensure accuracy, timeliness, and accountability
Identify gaps or inconsistencies in vendor performance and escalate appropriately
Ensure alignment between internal workflows and vendor processes
Participate in regular vendor meetings and performance reviews
Oversee month-end close activities related to the revenue cycle
Review and reconcile payments, adjustments, and accounts receivable balances
Reconcile bank deposits, lockbox activity, and payment posting accuracy
Identify and resolve discrepancies between billing system, clearinghouse, and bank activity
Review suspense accounts and ensure timely resolution
Partner with finance leadership to ensure reporting accuracy and revenue integrity
Own and manage all revenue cycle tasks that remain internal to VSON, including: Charge capture accuracy and follow-up, Coding coordination and provider communication, Workflow management across departments impacting billing
Partner with clinical, front desk, and ancillary teams to ensure accurate and complete information flow
Oversee denial trends and root cause analysis
Approve and guide appeal strategies for complex or high-value denials
Own escalation of billing issues including denials, posting discrepancies, and payer challenges
Ensure timely and effective AR follow-up (internal and vendor-driven)
Establish and maintain standards for charge capture and revenue integrity
Partner with providers and coding resources to ensure documentation quality and medical necessity
Identify trends impacting coding accuracy and reimbursement
Support clinical documentation improvement efforts
Identify breakdowns in workflows and implement corrective actions
Recommend and implement process improvements to increase efficiency and reduce revenue leakage
Ensure alignment of workflows across departments and vendor partners
Resolve complex patient billing issues and escalations
Serve as the internal escalation point for revenue cycle-related concerns
Support front desk and clinical teams with billing-related questions and process clarity
Provide guidance and training to staff on revenue cycle processes and expectations
Support onboarding and education across departments impacting billing
Act as internal subject matter expert for revenue cycle operations
Partner with leadership on reporting, performance improvement, and strategic initiatives