Director of Revenue Cycle

JOB SUMMARY:
The Director of Revenue Cycle provides executive leadership and strategic oversight for the organization’s revenue cycle operations, including the Business Office, Health Information Management (HIM), and Registration departments. This role is responsible for ensuring accurate, efficient, and compliant revenue cycle processes while serving as the organization’s HIPAA Compliance Officer. The Director develops, implements, and monitors policies and procedures that optimize financial performance, enhance patient experience, maintain regulatory compliance, and support organizational goals.

ESSENTIAL FUNCTIONS:

• Lead and manage the Business Office, HIM, and Registration teams, including hiring, training, performance management, and professional development.
• Serve as the HIPAA Compliance Officer, ensuring the organization’s adherence to all federal, state, and local privacy regulations, including patient confidentiality and data security.
• Develop, implement, and maintain policies, procedures, and workflow improvements to optimize revenue cycle performance and reduce denials.
• Create and Monitor key performance indicators (KPIs) across the revenue cycle, including patient account resolution, billing accuracy, collections, accounts receivable, and insurance follow-up.
• Collaborate with leadership to establish financial and operational goals, including strategic planning and budgeting for revenue cycle departments.
• Oversee coding and documentation accuracy, ensuring compliance with payer requirements and industry coding standards.
• Partner with clinical and administrative departments to improve patient registration, billing processes, and documentation practices.
• Conduct regular audits and reviews to ensure adherence to regulatory and organizational compliance standards.
• Provide guidance and training to staff on HIPAA regulations, revenue cycle best practices, and organizational policies.
• Serve as a resource for complex account resolution, escalated billing inquiries, and insurance negotiations.
• Evaluate and implement technology solutions to enhance workflow efficiency, reporting, and data integrity.
• Develop payer relationships and escalate claim resolution as needed.

• Education:
  • Bachelor’s degree in Health Information Management, Business Administration, Healthcare Administration, or related field required; Master’s degree preferred.

• Experience:

• Minimum of 7–10 years of progressive experience in revenue cycle management, including leadership experience in Business Office, HIM, or Registration departments.
• Experience serving as a HIPAA Compliance Officer or overseeing compliance initiatives strongly preferred.
• Knowledge of healthcare billing, coding, payer contracts, and revenue cycle best practices.
• Experience with CPSI–TruBridge or similar EMR/RCM systems preferred.

• Skills:

• Strong leadership, communication, and interpersonal skills.
• Ability to analyze complex financial and operational data to drive performance improvements.
• Demonstrated ability to lead multiple departments, manage change, and implement process improvements.
• High level of integrity, discretion, and professionalism in handling confidential information.
• Ability to work collaboratively with physicians, clinical staff, and executive leadership.

This job description is not intended as an all-inclusive list of responsibilities that may be assigned and is subject to change based on the needs of the organization.