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Director of Revenue

Soni
Boston, MA Full Time
POSTED ON 10/18/2025
AVAILABLE BEFORE 11/14/2025

The Senior Medical Revenue Specialist is responsible for leading all aspects of the revenue cycle, including patient billing, insurance claims, collections, grants receivables, and payer contracting for a healthcare-focused nonprofit organization. This role ensures the integrity of revenue processes, supports sustainable financial operations, and aligns revenue strategies with the organization's mission to improve community health outcomes.


Key Responsibilities:

Revenue Cycle Management

  • Oversee all functions of the revenue cycle including patient registration, charge capture, coding, billing, collections, and denial management.
  • Monitor and improve KPIs such as Days in A/R, cash collections, and denial rates.
  • Collaborate with clinical and administrative teams to ensure accurate documentation and coding.

Financial Strategy & Analysis

  • Develop revenue forecasts and support budgeting processes.
  • Analyze trends and variances in revenue streams (e.g., Medicaid/Medicare, commercial insurance, private pay, grants).
  • Recommend and implement strategies to optimize reimbursements and improve efficiency.

Payer Relations & Contracting

  • Manage relationships with third-party payers and negotiate reimbursement rates and terms.
  • Ensure compliance with payer guidelines, government regulations, and grant requirements.

Compliance & Risk Management

  • Maintain up-to-date knowledge of regulatory requirements (HIPAA, CMS, etc.).
  • Ensure billing practices align with legal and ethical standards.
  • Lead internal audits and address findings related to billing and revenue processes.

Leadership & Team Development

  • Supervise and develop revenue cycle staff, providing coaching, performance management, and training.
  • Foster a culture of accountability, transparency, and continuous improvement.


Qualifications:

Education:

  • Bachelor’s degree in Finance, Accounting, Health Administration, or related field required.
  • Master’s degree (MBA, MHA, MPH) preferred.
  • Certified Revenue Cycle Professional (CRCP) or similar certification a plus.

Experience:

  • Minimum 7–10 years of progressive experience in healthcare revenue cycle management.
  • At least 3 years in a leadership role within a nonprofit or healthcare setting.
  • Strong knowledge of Medicaid/Medicare billing, FQHC or behavioral health billing is highly desirable.

Skills:

  • Proficiency with revenue cycle systems and electronic health records
  • Strong analytical, strategic thinking, and problem-solving skills.
  • Excellent communication and interpersonal abilities.
  • Commitment to the mission and values of nonprofit healthcare.


Compensation: $100,000 to $115,000 annually

Salary is based on a range of factors that include relevant experience, knowledge, skills, other job-related qualifications.

Salary : $100,000 - $115,000

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