Revenue Cycle Director

  • 51497
  • 13 Aug 2019
  • Miami Lakes, FL
  • Accounting & Finance
  • Confidential

Job Description

Revenue Cycle Director

Job Summary

A critical function of this position is to provide support to, and participation with, Executive Leadership in facilitating the implementation of systems, processes, and procedures to insure regulatory compliance, and maintaining an awareness of changes in healthcare matters that directly or indirectly impact the revenue of the company. This role manages exempt and non-exempt level employees and has both strategic and operational oversight across the RCO. This position is critical in establishing and developing vendor partnerships for Data, Remittance, and Collection Agency services among other contractual partnerships. The Manager has direct ownership of revenue and cash flow integrity, payer contract maintenance, technology integrations and budget responsibilities. The Manager will champion the overall RCO including financial planning activities. The position will communicate with insurance carriers and work collaboratively with department heads and external business groups to identify systemic issues, develop solutions, and implement process changes. This position will also oversee the recognition and analysis of reimbursement for all payers for financial statement reporting and make recommendations and/or changes to optimize cash flow. The Manager shall have primary responsibility for managing and reviewing all correspondence with payers to understand related impact on revenue recognition and cash flows. At all times, the position shall represent the organization in a professional manner while effectively driving collections to meet business objectives.


  • Dexterous individual with the talent to meet a continually changing set of circumstances.
  • Extensive knowledge and understanding of regulations relating to Medicare, Medicaid and commercial insurance providers.
  • Proven revenue reporting and analytical skills. Leadership experience in managing teams across multiple sites with a healthcare focus.
  • Excellent verbal and written communication skills. Very strong strategic, vision and process change improvement leader.
  • Advanced proficiency in revenue recognition and accounts receivable management.
  • Strong analytical, problem solving, root cause analysis skills to evaluate problems and interpret trends.
  • Experience in business office and call center management, medical billing, accounts receivable collections and healthcare background required including Medicare and Medicaid billing requirements.
  • Demonstrated process improvement, project management, workflow, benchmarking and evaluation of business processes required. Advanced knowledge of Microsoft Office.
  • Understanding of Healthcare Markets, Economics and Health Plans. Active participation in HFMA and ACHE.
  • BS in Accounting, Finance or Business. Master's in Business Administration or Healthcare preferred. HFMA Certification preferred.
  • Strong written, verbal communication and relationship building skills.
  • Must have very strong problem-solving skills as well as a strong attention to detail.
  • Able to multi-task, meet tight deadlines while managing time effectively.
  • Prior working knowledge and experience with medical EHR/billing systems strongly preferred,
  • Extremely strong analytical and mathematical skills.
  • Very strong Excel skills and strong MS Word and Outlook skills.
  • Knowledge of CPT-4/HCPC, ICD-10-CMJ, UB-04 and HCFA 1500 bill forms strongly preferred.
  • Familiar with third party billing practices, contracts and regulations including but not limited to Managed Care Organizations and government payers strongly preferred.

Job Responsibilities

  • Manage operational and financial aspects ensuring an effective revenue cycle, including oversight of accounts receivable, insurance verification, high volume medical billing, managed care collections, data services, remittance services, adjustments processing, and quality control.
  • Oversight, review and preparation of Bad Debt, ensuring a walk forward schedule clearly substantiates all revenues, transfers, collections, adjustments and other transactions impacting accounts receivable aging.
  • Oversight of daily, weekly, monthly, quarterly and yearly reports comprised of key performance indicators (KPIs); monitor and analyze charges, payments, adjustments, AR and other data elements.
  • Budgetary oversight of Revenue Cycle departments, facilities and organizational structure across multiple sites.
  • Maintains continual knowledge of payer policies to assure optimal reimbursement for all services performed within the system, in compliance with government and third-party payer regulations.
  • Provide statistics to assist audit reimbursement payments for year - end processing.
  • Assure current knowledge of State and Federal laws and regulations, reimbursement trends, and patient/member satisfaction pertaining to Revenue Cycle and Decision Support functions.
  • Resolves and escalates issues within Revenue Cycle departments.
  • Management duties including, but not limited to, hiring, training, and developing staff.
  • Prepare and submit reports on a timely basis as required and directed by Executive Leadership.
  • Contribute financial expertise in the planning of new services that generate additional sources of profitable revenue.
  • Ensure the organization meets necessary financial regulatory and compliance requirements.
  • Develop best practices for process improvement for overall Revenue Cycle management.
  • Manage costs by continually seeking data that will identify opportunities and take action to eliminate non-value costs in conjunction with the hospital's Executive Leadership Team.
  • Analyzing areas in planning, promoting and conducting system-wide performance improvement activities.
  • Participating in the company's monthly operation reviews.
  • Manage large-scale projects driving process change improvements and policies throughout the company.
  • Drive facility and functional consolidation and re-organization as business needs dictate for cost efficiency and compliance performance.

The ideal candidate will have minimum 5 years’ experience managing the Revenue Cycle Operations (RCO)


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