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Director of Revenue Cycle Management

Orthopaedic Specialty Group
Shelton, CT Full Time
POSTED ON 1/16/2025
AVAILABLE BEFORE 4/13/2025

The Director of Revenue Cycle Management is responsible for overseeing and optimizing the entire revenue cycle process, from patient registration and insurance verification to billing, collections, and financial reporting. This role ensures that the organization maximizes revenue, minimizes losses, and adheres to all regulatory requirements. The Director will lead a team of revenue cycle professionals and work closely with clinical and administrative staff to streamline processes and improve overall financial performance.

Key Responsibilities :

Leadership and Management :

  • Lead, mentor, and develop a team of revenue cycle professionals.
  • Establish performance goals and conduct regular performance evaluations.
  • Foster a collaborative and productive work environment.

Revenue Cycle Operations :

  • Oversee patient registration, insurance verification, billing, coding, collections, and payment posting.
  • Ensure compliance with all federal, state, and local regulations related to billing and collections.
  • Develop and implement policies and procedures to optimize revenue cycle processes.
  • Financial Performance :

  • Monitor and analyze key performance indicators (KPIs) related to the revenue cycle.
  • Identify areas for improvement and implement strategies to enhance revenue and reduce denials.
  • Prepare regular financial reports for senior management
  • Technology and Systems :

  • Evaluate and implement revenue cycle management software and technologies.
  • Ensure proper integration of electronic health records (EHR) with billing systems.
  • Stay current with industry trends and advancements in revenue cycle technology.
  • Patient Relations :

  • Develop and maintain positive relationships with patients, ensuring their billing and payment experiences are smooth and transparent.
  • Address and resolve patient billing inquiries and disputes in a timely manner.
  • Compliance and Regulatory Affairs :

  • Ensure the organization's revenue cycle processes comply with all applicable regulations.
  • Conduct regular audits and assessments to identify compliance risks and areas for improvement.
  • Collaboration :

  • Work closely with clinical and administrative departments to ensure alignment and cooperation in revenue cycle processes.
  • Collaborate with external partners, such as insurance companies and third-party vendors.
  • Credentialing :

  • Oversee the credentialing process for healthcare providers to ensure compliance with all regulatory and accreditation standards.
  • Maintain accurate and up-to-date credentialing records.
  • Coordinate with providers and payers to facilitate timely and accurate credentialing.
  • Qualifications :

  • Education : Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field. Master's degree preferred.
  • Experience : Minimum of 7-10 years of experience in healthcare revenue cycle management, with at least 5 years in a leadership role.
  • Certifications : Certified Revenue Cycle Executive (CRCE) or similar certification preferred.
  • Skills :
  • Strong leadership and team management skills.

  • In-depth knowledge of revenue cycle processes and best practices.
  • Excellent analytical and problem-solving abilities.
  • Proficiency with revenue cycle management software and EHR systems.
  • Strong communication and interpersonal skills.
  • Ability to work in a fast-paced, dynamic environment.
  • Knowledge of credentialing processes and requirements.
  • Orthopaedic Specialty Group, P.C., is an Equal Opportunity Employer.

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