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Director of Revenue Cycle
REMOTE – Must live in Southeast Georgia area
Up to $120k

A leadership role responsible for directing and optimizing all aspects of revenue cycle management, including medical coding, accounts receivable, reimbursement, and collections.

Key Responsibilities:

• Train, mentor, and evaluate team members, recommending promotions and corrective actions as needed.

• Address and resolve complex insurance claim disputes.

• Analyze and track insurance reimbursement trends to ensure compliance with financial targets.

• Oversee department operations to ensure financial efficiency within budget constraints.

• Stay updated on industry trends and adjust processes to comply with changing medical insurance regulations.

• Assess and refine health insurance claim procedures to enhance productivity and accuracy.

• Lead claim filing and resolution efforts with various insurers and agencies to maximize reimbursements through strategic financial planning.

• Maintain and update contract terms, fee schedules, and reimbursement grids based on procedure codes.

• Oversee account collections, manage Medicare bad debt records, and coordinate outsourced accounts receivable processes.

• Supervise the coding process to enhance accuracy and cost efficiency in claim submissions.

• Manage department correspondence, prepare reports, and maintain essential records.

• Ensure adherence to company policies and regulatory standards.

• Assist with maintaining department equipment and supply inventory.

• Participate in required meetings and serve on committees as needed.

• Pursue professional growth opportunities and maintain industry certifications or affiliations.

• Safeguard patient confidentiality in all processes.

Education:

• Bachelor’s degree required.

Experience:

• At least five years of supervisory experience in a healthcare revenue cycle setting.

Competencies & Qualifications:

Knowledge:

• Strong knowledge of medical billing, collections, and insurance claims processes.

• Proficiency in medical coding, including CPT, diagnosis, and HCPCS codes.

• Comprehensive understanding of medical office operations.

• Familiarity with insurance provider policies, contracts, and payment structures.

• Expertise in precertification and authorization for physicians, hospitals, and surgical centers.

• Understanding of legal and regulatory guidelines affecting billing and collections.

• Proficiency in data analysis, system workflows, and medical data processing.