Director of Revenue Cycle - Accounts Receivable

Director of Revenue Cycle - Accounts Receivable | Summit Healthcare Mgmt | Franklin, Tennessee

About the Job:

PURPOSE STATEMENT:

The Director-Revenue Cycle-Accounts Receivable is responsible for leading and optimizing daily insurance follow-up, denial management, and accounts receivable operations across the revenue cycle. This role provides both strategic direction and hands-on operational oversight to accelerate cash collections, reduce aged receivables, minimize avoidable write-offs, and strengthen denial prevention and recovery performance.

The Director partners cross-functionally to resolve payment barriers, improve first-pass resolution, and ensure consistent, high-quality execution of follow-up and denial workflows across all payer classes, including government, commercial, managed care, and self-pay.

Roles and Responsibilities:

ESSENTIAL FUNCTIONS:

• Lead end-to-end collections, denial management, and insurance follow-up operations, maintaining close visibility into daily performance and workflow execution.
• Oversee and actively monitor work queues, aging reports, denial inventories, underpayment follow-up, and escalation pathways.
• Ensure productivity, quality, and account resolution standards are consistently achieved across all teams and functions.
• Establish, refine, and enforce standard work, operational policies, and escalation protocols.
• Partner with revenue cycle leadership to identify systemic barriers to reimbursement and implement targeted corrective actions.
• Maintain direct engagement with frontline operations to ensure alignment between strategy and execution.
• Direct all denial management activities including intake, classification, prioritization, trending, prevention, and appeals.
• Ensure timely and accurate denial resolution and appeal submission within payer filing requirements.
• Maintain active oversight of high-volume and high-dollar denial categories, intervening directly where needed to remove barriers.
• Collaborate with Patient Access, HIM, Coding, Case Management, Utilization Review, Billing, and Clinical teams to address root causes and reduce recurrence.
• Develop, review, and act on denial dashboards, trends, and action plans.
• Escalate payer-specific and systemic denial issues, partnering with contracting, compliance, and operations on resolution strategies.
• Lead daily insurance follow-up activities with a focus on maximizing reimbursement and reducing AR aging.
• Ensure timely resolution of underpayments, no-response claims, rejections, payer correspondence, and credit balance-related issues.
• Monitor payer performance including turnaround times, responsiveness, and adherence to contractual obligations.
• Identify trends impacting collections and implement workflow, staffing, or system improvements.
• Maintain hands-on awareness of complex, escalated, or high-value accounts to ensure timely resolution.
• Support clean-claim and first-pass yield initiatives through collaboration with billing, coding, and front-end teams.
• Lead a multi-layered team including managers, supervisors, team leads, and frontline staff.
• Provide ongoing coaching, quality oversight, and performance management tied to productivity, accuracy, and outcomes.
• Oversee hiring, onboarding, staffing models, and workforce planning to support volume and growth.
• Promote a culture of accountability, urgency, ownership, and continuous improvement.
• Ensure teams are trained on payer requirements, denial trends, and evolving workflows.
• Analyze accounts receivable, denial, cash, and productivity data to identify trends, risks, and opportunities.
• Maintain regular review of operational dashboards and KPIs, taking corrective action as needed.
• Prepare and present performance summaries and insights to senior leadership.
• Monitor and drive improvement in key metrics including:
• AR days and aging (90 and 120 )
• Denial rates and overturn rates
• Timely filing write-offs
• Accounts worked per FTE
• Gross and net collection rates
• Payer-specific performance trends
  
  
  

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field preferred; equivalent relevant experience may be considered in lieu of degree.
• Five or more years of progressive healthcare revenue cycle experience required.
• Experience in hospital, behavioral health, acute care, physician revenue cycle, or multi-site healthcare operations preferred.
• Strong knowledge of payer reimbursement, denial management, appeals, claims adjudication, and account resolution workflows.
• Working knowledge of payer rules, timely filing requirements, authorization requirements, and reimbursement regulations.
• Strong analytical, problem-solving, leadership, and communication skills.
• Proficiency with EMR/PMS platforms, clearinghouses, payer portals, and Microsoft Excel.
• Experience in behavioral health, SUD, acute psych, or multi-facility healthcare environments preferred.
  
  
  

LICENSES/DESIGNATIONS/CERTIFICATIONS:

HFMA, CRCR, or similar revenue cycle certification preferred.

WORK LOCATION:

This is a remote position.

SUPERVISORY REQUIREMENTS:

Three or more years of leadership experience in collections, denial management, accounts receivable follow-up, or related functions required.

Why Summit Healthcare Mgmt?Summit Healthcare Mgmt offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Qualified candidates should apply by submitting a resume. Summit Healthcare Mgmt is an EOE.

Veterans and military spouses are highly encouraged to apply. Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.