Director of Revenue Cycle

Oklahoma Arthritis Center (OAC) is an Equal Employment Opportunity employer and considers all applicants without regard to race, religion, color, sex, national origin, age, disability, veteran status, or any other legally protected status.

Job Summary:

The Revenue Cycle Director is responsible for developing and overseeing the structure of Revenue Cycle Management, ensuring financial integrity, and maintaining compliance with regulatory requirements. This leadership role provides strategic direction for revenue cycle operations, including billing, coding, claims management, and reimbursement functions. The Revenue Cycle Director will identify improvement strategies, optimize processes, and implement internal controls to ensure efficiency and maximize revenue while maintaining compliance with payer regulations.

This position will lead a team environment, coordinate functional and technical activities, and establish the strategic direction for revenue cycle management. The role requires expertise in revenue cycle reporting, financial analysis, and compliance monitoring to drive continuous improvement and financial performance.

Essential Functions:

• Develop and structure the revenue cycle division, ensuring clarity in responsibilities and workflows.
• Oversee the development of revenue cycle programs, processes, and operational policies – including those of the billing department, financial coordination, and other departments that are or will be apart of the revenue cycle division
• Oversee complex business decision-making for prior-authorization, coding, and billing operations.
• Identify, establish, and implement internal controls to ensure a compliant and efficient revenue cycle environment.
• Lead, manage, and develop a multi-disciplinary revenue cycle team.
• Synthesize various subject matter expert inputs to formulate solutions for complex technical issues.
• Interpret and implement billing rules, regulatory compliance policies, and payer regulations.
• Assure the integrity, accuracy, and stability of revenue and billing data.
• Identify strategies that lead to improved financial performance while maintaining compliance and operational excellence.
• Assist executive team in the creation of key revenue cycle goals with significant institutional impact.
• Monitor revenue cycle goals and oversee reporting to identify trends, anomalies, and improvement opportunities.
• Establish and oversee a structured reporting cadence to track revenue cycle performance:

• • Daily Reports: Claim submission summary, charge capture reconciliation, new patient registration, daily deposit reports.
  • Weekly Reports: AR aging report, denial management analysis, top payer performance, clearinghouse edits, patient balance follow-up.
  • Monthly Reports: Gross collection rate, provider productivity, charge/payment analysis, adjustment analysis, insurance write-off percentage.
  • Quarterly Reports: Trend analysis of key metrics (e.g., days in AR, denial rates), payer mix analysis, coding accuracy review, performance benchmarking.
  • Yearly Reports: Revenue cycle performance summary, budget variance analysis, strategic planning data, contract negotiation analysis.
• Direct and oversee the performance of revenue cycle staff, ensuring departmental goals are met.
• Participate in the recruitment, training, development, and performance management of revenue cycle staff.
• Lead and implement change management initiatives within revenue cycle operations.
• Manage and prioritize resources across multi-site teams, ensuring operational efficiency.
• Collaborate with executive leadership to align revenue cycle strategies with organizational goals.
• Fill in for personnel when they are out, for example the Billing Manager

Performance Requirements:

Knowledge: 

• In-depth knowledge of revenue cycle processes (patient registration, charge capture, coding, billing, collections, denials, reimbursement).
• Strong understanding of healthcare finance, payer contracting, reimbursement models, and revenue integrity.
• Knowledge and understanding of revenue cycle reports.
• Knowledge of HIPAA, CMS guidelines, ICD-10, CPT coding, and billing compliance.

Skills:

• Skills in customer service and diffusion of highly intense interactions and situations.
• Strong leadership, decision-making, and conflict resolution skills.
• Excellent written and verbal communication skills for interaction with executives, physicians, payers, and staff.
• Proficiency in computer programs including Microsoft Office suite including Microsoft Excel, Microsoft Word and Microsoft Outlook, and          Electronic Health Records (EHR), Practice Management (PM), and Revenue Cycle Management (RCM) systems.
• Strong data analysis skills to identify trends, improve processes, and drive revenue optimization
• Skills in strategic planning and execution of initiatives.

Abilities: 

• Ability to effectively interacting with patients, visitors, providers, administration and all staff members.
• Ability to assume responsibility and exercise authority over assigned work functions
• Ability to recognize, evaluate, solve problems and correct errors.
• Ability to conceptualize work flow, develop plans and implement appropriate actions.
• Ability to establish priorities and coordinate work activities.
• Ability to implement automation, AI, and technology solutions to improve efficiency
• Ability to exercise a high degree of initiative, judgment, discretion and decision-making to achieve organizational goals.
  

Qualifications:

Required Education:

• Bachelor’s degree in Accounting, Finance, Economics, Management Information Systems (MIS), Health Information Management (HIM),                Healthcare Administration, Business Administration (BBA), or related fields.
• In some cases, 5 years of healthcare revenue cycle management experience may substitute for a bachelor's degree.

Preferred Education:

• Master’s degree in Healthcare Administration (MHA), Business Administration (MBA), Science in Health Informatics (MSHI),                                      Accounting/Finance, Healthcare Financial Management, Management Information Systems (MSMIS), or related fields.

Preferred Certifications:

• Certified Revenue Cycle Representative (CRCR), Certified Healthcare Financial Professional (CHFP), Certified Professional Coder (CPC),              Certified Coding Associate (CCA), Certified Outpatient Coder (COC), Certified Professional Biller (CPB), Certified Rheumatology Coder                    (CRC).

Required Experience:

• Minimum of 4 years in a management role related to healthcare revenue cycle, billing, or finance.
• A master’s degree may be considered as a substitute for the required years of experience.

Preferred Experience:

• Experience with insurance claims processing, Medicare/Medicaid regulations, and managed care.
• Experience leading and developing multi-disciplinary teams, including billing, coding, and patient services.
• Experience working cross-functionally with clinical and administrative teams.
• Experience with budgeting, forecasting, and financial reporting.
• Experience in healthcare department or team restructuring.

Physical Requirements:

• Ability to work effectively in a fast-paced environment.
• Physical ability to sit, perform data entry and view computer screen for long periods at a time.
• Occasional exposure to communicable diseases and biohazards.
• Daily standing, walking, bending, and maneuvering.
• May require lifting up to 50 pounds or more to transfer and/or turn patient with and without assistive devices.

Travel:
Travel may be required.

Scheduled Working Hours:
Professional salary exempt positions are expected to work at least 40 hours per week and be onsite during regular clinic work hours, which are 8:00 a.m. to 5:00 p.m., Monday through Thursday and 8:00 a.m. to 1:00pm. on Fridays. Additional hours may vary depending upon the needs of the position, department, and clinic.

Other Duties:

Please note this job description is not designed to cover or to contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change from time to time, with or without notice.

Equipment:

Standard office equipment including: computers, printers, faxes, copiers, postage machine, etc.