Director of Revenue Operations

Director of Revenue Cycle

REMOTE - Must live in Southeast Georgia area

Up to $120k

A leadership role responsible for directing and optimizing all aspects of revenue cycle management, including medical coding, accounts receivable, reimbursement, and collections.

Key Responsibilities:

• Train, mentor, and evaluate team members, recommending promotions and corrective actions as needed.
• Address and resolve complex insurance claim disputes.
• Analyze and track insurance reimbursement trends to ensure compliance with financial targets.
• Oversee department operations to ensure financial efficiency within budget constraints.
• Stay updated on industry trends and adjust processes to comply with changing medical insurance regulations.
• Assess and refine health insurance claim procedures to enhance productivity and accuracy.
• Lead claim filing and resolution efforts with various insurers and agencies to maximize reimbursements through strategic financial planning.
• Maintain and update contract terms, fee schedules, and reimbursement grids based on procedure codes.
• Oversee account collections, manage Medicare bad debt records, and coordinate outsourced accounts receivable processes.
• Supervise the coding process to enhance accuracy and cost efficiency in claim submissions.
• Manage department correspondence, prepare reports, and maintain essential records.
• Ensure adherence to company policies and regulatory standards.
• Assist with maintaining department equipment and supply inventory.
• Participate in required meetings and serve on committees as needed.
• Pursue professional growth opportunities and maintain industry certifications or affiliations.
• Safeguard patient confidentiality in all processes.

Education:

• Bachelor’s degree required.

Experience:

• At least five years of supervisory experience in a healthcare revenue cycle setting.

Competencies & Qualifications:

Knowledge:

• Strong knowledge of medical billing, collections, and insurance claims processes.
• Proficiency in medical coding, including CPT, diagnosis, and HCPCS codes.
• Comprehensive understanding of medical office operations.
• Familiarity with insurance provider policies, contracts, and payment structures.
• Expertise in precertification and authorization for physicians, hospitals, and surgical centers.
• Understanding of legal and regulatory guidelines affecting billing and collections.
• Proficiency in data analysis, system workflows, and medical data processing.