Director Operations ( Revenue Cycle Management)

Overview
The Director Operations (RCM) is responsible for leading end-to-end revenue cycle operations with a strong focus on billing, prior authorization, denials, and appeals management. This role ensures operational performance, regulatory compliance, and delivery against client and organizational objectives. The Operations Manager oversees large-scale teams, manages inventory and workflow, and implements strategies to improve collections, reduce denials, and optimize revenue outcomes. This position requires a deep understanding of billing systems, payer requirements, and denial management processes, while driving cross-functional collaboration and continuous improvement. Performs other duties as assigned.

Responsibilities

• Lead and oversee daily operations across billing, eligibility, prior authorization, denials,appeals, AR follow-up, and payment posting functions
• Manage and develop large teams (100 FTEs), including direct supervision, coaching,performance management, and employee development
• Direct denials management operations, including research, appeals, reimbursement analysis, and follow-up on pending claims
• Ensure timely, accurate submission of claims and resolution of accounts to maximize reimbursement and minimize denials
• Analyze reimbursement trends, payer behavior, and denial patterns to drive corrective actions and improve outcomes
• Oversee inventory management, workload distribution, and prioritization to ensure timely execution and reduce aging risk
• Collaborate with cross-functional teams (HR, IT, Compliance, Quality, Training) to support operational initiatives and process improvements
• Act as a liaison across departments to ensure alignment, communication, and execution of revenue cycle initiatives
• Monitor adherence to policies, procedures, and compliance requirements, including auditing and quality assurance activities
• Provide reporting and insights to leadership and clients, including operational performance, KPIs, and improvement plans
• Lead Monthly Business Reviews (MBRs) and support client-facing discussions
• Support hiring, onboarding, training, and ongoing development of team members
• Foster a high-performance culture focused on accountability, engagement, and retention
• Ensure proper payer setup, eligibility validation, and billing system accuracy
• Maintain confidentiality and ensure proper handling of Protected Health Information (PHI)

Qualifications & Requirements:

• Bachelor’s degree required (or equivalent experience)
• 8 years of experience in end-to-end Revenue Cycle Management (RCM)
• Minimum 3 years of leadership experience in a high-volume billing or denials management environment
• Experience managing large teams (100 FTEs) in fast-paced operations
• Laboratory billing experience preferred

Technical & Functional Expertise:

• Strong knowledge of reimbursement, billing, coding, and healthcare compliance regulations
• Deep understanding of payer eligibility, benefits, and denial management processes
• Experience with billing systems and revenue cycle platforms
• Proficiency in Microsoft Office Suite, particularly Excel and PowerPoint
• Ability to perform complex data analysis and present findings to leadership

Pay: $80,000.00 - $100,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Retirement plan
• Vision insurance

Work Location: In person

Salary : $80,000 - $100,000