NextPlay Jobs
POSITION OVERVIEW
The Director of Revenue Cycle Management provides senior-level leadership for all aspects of the organization’s revenue cycle functions, including Business Office operations, Health Information Management (HIM), and Patient Registration. This position is accountable for the integrity, efficiency, and compliance of revenue cycle activities and serves as the organization’s designated HIPAA Compliance Officer. The Director establishes and oversees policies, procedures, and performance standards that support financial sustainability, regulatory compliance, operational effectiveness, and a positive patient experience.
KEY RESPONSIBILITIES Direct and oversee Business Office, HIM, and Registration departments, including staffing, onboarding, performance evaluation, coaching, and ongoing professional development. Act as the organization’s HIPAA Compliance Officer, ensuring adherence to all applicable federal, state, and local privacy and security regulations related to protected health information. Design, implement, and continuously refine revenue cycle policies, procedures, and workflows to improve accuracy, timeliness, and denial prevention. Establish, track, and analyze key performance metrics across the revenue cycle, including billing accuracy, accounts receivable, collections, insurance follow-up, and account resolution. Collaborate with executive and operational leadership to support organizational objectives through strategic planning, departmental goal-setting, and budget development. Provide oversight of coding and clinical documentation processes to ensure compliance with payer guidelines, regulatory requirements, and recognized coding standards. Partner with clinical, administrative, and support departments to enhance registration accuracy, documentation quality, billing efficiency, and overall patient financial processes. Conduct routine audits, assessments, and internal reviews to verify compliance with regulatory standards, internal policies, and best practices. Deliver education and guidance to staff regarding HIPAA requirements, revenue cycle procedures, and organizational policies and expectations. Serve as an escalation point for complex patient accounts, disputed claims, high-level billing issues, and payer-related challenges. Assess, recommend, and implement technology tools and system enhancements that improve workflow efficiency, reporting capabilities, and data accuracy. Build and maintain effective relationships with payers and facilitate escalation and resolution of complex or unresolved claims when necessary.
QUALIFICATIONS Education Bachelor’s degree in Healthcare Administration, Health Information Management, Business Administration, or a related discipline required Master’s degree preferred
Experience Seven to ten years of progressively responsible experience in revenue cycle management, including leadership roles within Business Office, HIM, or Registration functions Prior experience serving as a HIPAA Compliance Officer or leading compliance initiatives strongly preferred Comprehensive knowledge of healthcare billing, coding, payer requirements, and revenue cycle best practices Experience with CPSI–TruBridge or comparable electronic medical record and revenue cycle systems preferred
Skills & Competencies Proven leadership ability with strong communication and relationship-building skills Advanced analytical skills with the ability to interpret financial and operational data to drive improvement Demonstrated success managing multiple departments and leading organizational change initiatives High degree of professionalism, discretion, and ethical judgment when handling sensitive information Ability to collaborate effectively with physicians, clinical teams, and executive leadership
KEY RESPONSIBILITIES Direct and oversee Business Office, HIM, and Registration departments, including staffing, onboarding, performance evaluation, coaching, and ongoing professional development. Act as the organization’s HIPAA Compliance Officer, ensuring adherence to all applicable federal, state, and local privacy and security regulations related to protected health information. Design, implement, and continuously refine revenue cycle policies, procedures, and workflows to improve accuracy, timeliness, and denial prevention. Establish, track, and analyze key performance metrics across the revenue cycle, including billing accuracy, accounts receivable, collections, insurance follow-up, and account resolution. Collaborate with executive and operational leadership to support organizational objectives through strategic planning, departmental goal-setting, and budget development. Provide oversight of coding and clinical documentation processes to ensure compliance with payer guidelines, regulatory requirements, and recognized coding standards. Partner with clinical, administrative, and support departments to enhance registration accuracy, documentation quality, billing efficiency, and overall patient financial processes. Conduct routine audits, assessments, and internal reviews to verify compliance with regulatory standards, internal policies, and best practices. Deliver education and guidance to staff regarding HIPAA requirements, revenue cycle procedures, and organizational policies and expectations. Serve as an escalation point for complex patient accounts, disputed claims, high-level billing issues, and payer-related challenges. Assess, recommend, and implement technology tools and system enhancements that improve workflow efficiency, reporting capabilities, and data accuracy. Build and maintain effective relationships with payers and facilitate escalation and resolution of complex or unresolved claims when necessary.
QUALIFICATIONS Education Bachelor’s degree in Healthcare Administration, Health Information Management, Business Administration, or a related discipline required Master’s degree preferred
Experience Seven to ten years of progressively responsible experience in revenue cycle management, including leadership roles within Business Office, HIM, or Registration functions Prior experience serving as a HIPAA Compliance Officer or leading compliance initiatives strongly preferred Comprehensive knowledge of healthcare billing, coding, payer requirements, and revenue cycle best practices Experience with CPSI–TruBridge or comparable electronic medical record and revenue cycle systems preferred
Skills & Competencies Proven leadership ability with strong communication and relationship-building skills Advanced analytical skills with the ability to interpret financial and operational data to drive improvement Demonstrated success managing multiple departments and leading organizational change initiatives High degree of professionalism, discretion, and ethical judgment when handling sensitive information Ability to collaborate effectively with physicians, clinical teams, and executive leadership