What are the responsibilities and job description for the Director of Revenue Cycle position at Ellis County Coalitn For Hlth?
General Summary
The Director of Revenue Cycle provides executive-level leadership, strategic direction, and operational oversight of the organization’s entire revenue cycle across medical, behavioral health, and dental service lines. This role is responsible for optimizing financial performance, regulatory compliance, operational efficiency, and revenue integrity from patient access through final payment resolution.
The Director develops and implements long-term revenue cycle strategies aligned with organizational goals, ensures compliance with federal and state regulations (including FQHC requirements), leads payer contract strategy and negotiations, and drives continuous performance improvement initiatives. The position works collaboratively with executive leadership, clinical leadership, compliance, IT, and external revenue cycle partners to maximize reimbursement, improve cash flow, reduce denials, and enhance the patient financial experience.
DUTIES & RESPONSIBILITIES
- Provide strategic direction and long-term planning for all revenue cycle operations.
- Develop and execute revenue optimization strategies aligned with organizational financial goals.
- Serve as the executive subject matter expert on reimbursement methodologies, including FQHC Prospective Payment System (PPS) and encounter rate billing.
- Advise executive leadership on payer performance, reimbursement trends, regulatory changes, and revenue risks.
- Present financial and operational performance metrics to executive leadership and Board of Directors (as applicable).
- Oversee all aspects of the revenue cycle.
- Ensure clean claim submission rates meet or exceed industry benchmarks.
- Establish internal controls to ensure accurate and timely billing practices.
- Monitor and improve front-end processes that impact downstream revenue.
- Develop, monitor, and analyze key performance indicators (KPIs)
- Develop dashboards and financial reports with actionable recommendations.
- Lead root-cause analysis for revenue leakage and implement corrective action plans.
- Establish revenue forecasting models and support annual budget development.
- Ensure compliance with CMS, HRSA, state Medicaid, Medicare, commercial payer requirements, and FQHC billing regulations.
- Develop departmental policies, procedures, and standardized workflows.
- Coordinate with contracted revenue cycle management vendors (e.g., Altruis) to ensure performance expectations are met.
- Work collaboratively with clinical leadership to improve documentation and charge capture processes.
- Support grant-funded programs by ensuring accurate billing and reporting structures.
KNOWLEDGE, SKILLS & ABILITIES
- Executive-level leadership and strategic planning skills
- Advanced knowledge of healthcare reimbursement methodologies
- Strong financial acumen and analytical skills
- Expertise in FQHC billing and encounter-based reimbursement
- Deep understanding of CPT, ICD-10, HCPCS coding and compliance
- Strong negotiation and contract analysis skills
- Ability to interpret complex regulatory requirements
- Excellent communication and presentation skills
- Strong organizational and project management skills
EDUCATION & EXPERIENCE
- Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or related field required (Master’s degree preferred).
- Minimum of 5–7 years progressive revenue cycle leadership experience required.
- Minimum 3 years in a management or senior leadership role required.
- Experience in FQHC or community health center setting strongly preferred.
- Advanced working knowledge of CMS, Medicaid, Medicare, and commercial payer billing requirements required.
- Professional certification (preferred but not required):
- Certified Healthcare Financial Professional (CHFP)
- Certified Revenue Cycle Representative (CRCR)
Job Types: Full-time, Permanent
Benefits:
- Paid Time Off
- Paid Holidays
- Flexible Schedules
- Health insurance
- Dental insurance
- Vision insurance
- Long/Short Term Disability
- 401(k) matching
- Life insurance
License/Certification:
Work Location: In person, Waxahachie, TX