Revenue Cycle Director

POSITION SUMMARY

The Revenue Cycle Director provides strategic leadership and oversight for all revenue cycle operations, including billing, coding, health information management, accounts receivable, collections, credentialing, and electronic medical record (EMR) administration. This position is responsible for optimizing reimbursement, ensuring regulatory compliance, improving operational efficiency, and supporting a positive patient financial experience. The Revenue Cycle Director collaborates with organizational leadership to develop and implement policies, monitor key performance indicators, and ensure effective revenue cycle processes throughout River Hills Community Health Center.

DUTIES AND RESPONSIBILITIES

Revenue Cycle Leadership

1. Direct and oversee all revenue cycle functions, including coding, billing, accounts receivable, collections, credentialing, health information management, and EMR administration.

2. Develop, implement, and monitor policies, procedures, workflows, and performance standards to ensure efficient and compliant revenue cycle operations.

3. Analyze revenue cycle performance metrics, identify opportunities for improvement, and implement strategies to maximize reimbursement, improve cash flow, and reduce denials.

4. Ensure compliance with applicable federal, state, payer, HIPAA, and FQHC regulations related to billing, coding, documentation, reimbursement, and health information management.

Department Oversight

5. Provide leadership, supervision, training, coaching, and performance management for billing, coding, medical records, and EMR support staff.

6. Oversee medical records operations, release of information processes, document management, and compliance with health information regulations.

7. Ensure accurate and timely claims submission, payment posting, denial management, appeals, collections, and follow-up activities.

8. Oversee coding accuracy, provider documentation education, coding audits, and compliance with current coding standards and reimbursement requirements.

EMR and Credentialing

9. Serve as the organizational lead for EMR administration, system updates, workflow optimization, provider training, and implementation projects.

10. Oversee provider credentialing and payer enrollment activities to ensure uninterrupted participation with contracted payers and government programs.

Leadership and Compliance

11. Prepare and present reports related to revenue cycle performance, accounts receivable, compliance activities, and operational outcomes to leadership and the Board of Directors.

12. Collaborate with providers, department leaders, payers, auditors, and external partners to resolve operational and reimbursement issues.

13. Respond to patient concerns related to billing, coding, and medical records and promote excellent customer service throughout the revenue cycle.

14. Maintain confidentiality of patient and organizational information and comply with all organizational policies, Corporate Compliance Program requirements, and applicable laws and regulations.

15. Participate in committees, special projects, and organizational initiatives as assigned.

16. Perform other duties as assigned.

MINIMUM QUALIFICATIONS

Education

Bachelor’s degree in Health Information Management, Healthcare Administration, Business Administration, Finance, or related field preferred or a High School graduate with a combination of four years of undergraduate education and/or experience.

Licensure/Certification

One of the following certifications is preferred:

· Certified Professional Coder (CPC)

· Certified Coding Specialist (CCS or CCS-P)

· Registered Health Information Administrator (RHIA)

· Registered Health Information Technician (RHIT)

· Certified Revenue Cycle Representative (CRCR) or equivalent

Experience

· Minimum of five (5) years of progressively responsible experience in healthcare revenue cycle management and supervisory or management experience.

· Federally Qualified Health Center (FQHC) experience preferred.

Knowledge, Skills and Abilities

1. Thorough knowledge of healthcare reimbursement methodologies, revenue cycle operations, coding, billing, and compliance requirements.

2. Strong understanding of Medicare, Medicaid, commercial insurance, and FQHC regulations.

3. Knowledge of ICD-10-CM, CPT, HCPCS, and ADA coding systems.

4. Strong analytical, organizational, and problem-solving skills.

5. Effective leadership, communication, and interpersonal skills.

6. Ability to interpret regulations, contracts, and payer requirements.

7. Proficiency with electronic medical records, practice management systems, and Microsoft Office applications.

8. Ability to establish and maintain effective working relationships with patients, providers, staff, and external partners.

WORKING CONDITIONS

General office and healthcare clinic environment. Occasional travel between clinic locations and attendance at meetings, conferences, or training programs may be required.

PHYSICAL REQUIREMENTS

1. Requires sitting, standing, walking, bending, and reaching associated with normal office operations.

2. Requires visual acuity to perform required tasks and review computer screens and written materials.

3. Requires the ability to communicate effectively using a computer, telephone, and other office equipment.

4. Requires the ability to write legibly and read printed and electronic materials.

Benefits:

• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Retirement plan
• Vision insurance

Work Location: In person