Overview
The Director of Revenue Cycle - Accounts Receivable is responsible for leading and optimizing daily insurance follow-up, denial management, and accounts receivable operations within the revenue cycle. This role combines strategic leadership with hands-on operational oversight to accelerate cash collections, reduce aged receivables, minimize avoidable write-offs, and enhance denial prevention and recovery.
This position involves cross-functional collaboration to resolve payment barriers, improve first-pass resolution, and ensure consistent, high-quality execution of follow-up and denial workflows across all payer classes, including government, commercial, managed care, and self-pay.
Responsibilities
- Lead end-to-end collections, denial management, and insurance follow-up operations with close monitoring of daily performance and workflow execution.
- Oversee work queues, aging reports, denial inventories, underpayment follow-up, and escalation processes.
- Ensure productivity, quality, and account resolution standards are met across all teams.
- Develop, refine, and enforce standard work procedures, operational policies, and escalation protocols.
- Collaborate with revenue cycle leadership to identify systemic reimbursement barriers and implement corrective actions.
- Maintain direct engagement with frontline operations to align strategy and execution.
- Manage all denial management activities including intake, classification, prioritization, trending, prevention, and appeals.
- Ensure timely and accurate denial resolution and appeal submissions within payer filing requirements.
- Monitor high-volume and high-dollar denial categories and intervene as necessary.
- Work with Patient Access, HIM, Coding, Case Management, Utilization Review, Billing, and Clinical teams to address root causes and reduce recurrence.
- Develop and act on denial dashboards, trends, and action plans.
- Escalate payer-specific and systemic denial issues, partnering with contracting, compliance, and operations for resolution.
- Lead daily insurance follow-up activities focused on maximizing reimbursement and reducing accounts receivable aging.
- Ensure timely resolution of underpayments, no-response claims, rejections, payer correspondence, and credit balance issues.
- Monitor payer performance including turnaround times, responsiveness, and contractual adherence.
- Identify trends affecting collections and implement workflow, staffing, or system improvements.
- Maintain hands-on oversight of complex, escalated, or high-value accounts.
- Support clean-claim and first-pass yield initiatives through collaboration with billing, coding, and front-end teams.
- Lead a multi-layered team including managers, supervisors, team leads, and frontline staff.
- Provide coaching, quality oversight, and performance management focused on productivity, accuracy, and outcomes.
- Oversee hiring, onboarding, staffing models, and workforce planning to support volume and growth.
- Promote a culture of accountability, urgency, ownership, and continuous improvement.
- Ensure teams are trained on payer requirements, denial trends, and evolving workflows.
- Analyze accounts receivable, denial, cash, and productivity data to identify trends, risks, and opportunities.
- Regularly review operational dashboards and KPIs, taking corrective action as needed.
- Prepare and present performance summaries and insights to senior leadership.
- Monitor and drive improvement in key metrics including:
- AR days and aging (90+ and 120+ days)
- Denial rates and overturn rates
- Timely filing write-offs
- Accounts worked per full-time equivalent (FTE)
- Gross and net collection rates
- Payer-specific performance trends
Requirements
- Bachelor’s degree in Healthcare Administration, Business, Finance, or related field preferred; equivalent relevant experience may be considered.
- Minimum of five years progressive healthcare revenue cycle experience.
- Experience in hospital, behavioral health, acute care, physician revenue cycle, or multi-site healthcare operations preferred.
- Strong knowledge of payer reimbursement, denial management, appeals, claims adjudication, and account resolution workflows.
- Working knowledge of payer rules, timely filing requirements, authorization requirements, and reimbursement regulations.
- Strong analytical, problem-solving, leadership, and communication skills.
- Proficiency with EMR/PMS platforms, clearinghouses, payer portals, and Microsoft Excel.
- Experience in behavioral health, substance use disorder (SUD), acute psychiatric, or multi-facility healthcare environments preferred.
- Three or more years of leadership experience in collections, denial management, accounts receivable follow-up, or related functions.
Certifications
- HFMA, CRCR, or similar revenue cycle certification preferred.
Compensation & Benefits
The organization offers a comprehensive benefits plan and a competitive salary commensurate with experience and qualifications.
Location
This is a remote position.
Equal Opportunity
Veterans and military spouses are highly encouraged to apply. The employer is committed to serving veterans and values the unique strengths of the military community in supporting its mission.