Director of Revenue Cycle ManagementThe Village for Families and Children

Position Responsibilities

Revenue Cycle Operations

• Direct all revenue cycle activities, including billing, claims submission, payment posting, denial management, accounts receivable, and collections.
• Establish departmental goals, performance standards, and accountability measures aligned with organizational objectives.
• Ensure timely, accurate, and compliant charge capture, claim processing, and reimbursement.
• Oversee the resolution of claim edits, denials, rejections, and underpayments, implementing corrective actions when needed.
• Lead process improvement initiatives to enhance operational efficiency and reimbursement outcomes.

Compliance and Revenue Integrity

• Partner with Compliance and Clinical Operations to ensure adherence to billing, coding, and documentation requirements.
• Coordinate revenue cycle audits, payer reviews, and corrective action plans.
• Monitor regulatory and payer changes affecting Medicare, Medicaid, commercial insurance, and managed care reimbursement.
• Develop and maintain policies, procedures, and internal controls that support compliance and revenue integrity.

Credentialing and Payer Enrollment

• Oversee provider and organizational credentialing, recredentialing, payer enrollment, and revalidation activities.
• Collaborate with Human Resources and clinical leadership to support provider onboarding and employment status changes.
• Maintain accurate credentialing records and ensure timely completion of required submissions and renewals.

Payer Contract Administration

• Coordinate payer contract negotiations, renewals, and amendments in partnership with organizational leadership.
• Maintain payer contract records and monitor key contract milestones and requirements.
• Analyze reimbursement methodologies and contract performance to identify opportunities for improvement.
• Support implementation of new payer agreements and related operational changes.

Financial Reporting and Analysis

• Collaborate with Finance to reconcile billing activity, cash receipts, and revenue transactions.
• Develop and present key performance reports and revenue cycle metrics.
• Identify financial trends, potential revenue risks, and opportunities for operational improvement.
• Support budgeting, forecasting, and revenue planning processes.

Systems and Process Improvement

• Partner with Information Systems to optimize revenue cycle technology and reporting capabilities.
• Participate in system upgrades, testing, implementation, and process enhancements.
• Promote data integrity, reporting accuracy, and effective use of technology and automation.

Leadership and Staff Development

• Provide leadership, supervision, coaching, and performance management for revenue cycle staff.
• Promote professional development, cross-training, and succession planning.
• Foster a culture of accountability, collaboration, and continuous improvement.
• Perform other duties and special projects as assigned