Director of Revenue Cycle | New Opening at Hope in Springfield! Hope
- 3.4 Springfield, IL Job Details Full-time $80,000
- $120,000 a year 20 hours ago Qualifications Bachelor's degree Full Job Description Director of Revenue Cycle
- Full-time in Springfield, IL Salary = $80,000
- 120,000 annually (based on experience)
JOB SUMMARY
The Director of Revenue Cycle provides strategic leadership and operational oversight for all stages of the organization's financial intake workflows, including patient/client registration, billing, coding compliance, claims submission, and collections. This role is directly responsible for preventing revenue leakage, accelerating cash flow, minimizing payer denials, and leading the modernization of billing technology to support long-term organizational growth.
ESSENTIAL FUNCTIONS 1.
Strategic Revenue Leadership:
Design, implement, and monitor the end-to-end revenue cycle process to maximize reimbursement accuracy and maintain a healthy, predictable cash flow across all clinical sites. 2.
Authorization & Utilization Management:
Oversee the authorization pipeline to ensure seamless coordination between intake, clinical scheduling, and payer approvals; minimize unbilled therapy hours due to lapsed or incorrect authorizations. 3.
Team Management:
Directly supervise, mentor, and evaluate the performance of the billing, intake, and credentialing team, establishing clear productivity metrics and high standards for quality assurance. 4.
Denial Management & Analytics:
Build and maintain analytical data dashboards to track key performance indicators (KPIs) such as Days Sales Outstanding (DSO), clean claim rates, and denial trends; implement aggressive root-cause solutions to reduce recurring behavior-health payer rejections. 5.
Process Modernization & IT Optimization:
Identify bottlenecks in current systems and lead initiatives to integrate modern automation tools, electronic data interchanges (EDI), and advanced workflows between our ABA practice management/EHR software and Microsoft Business Central. 6.
Payer & Contract Compliance:
Serve as the primary point of contact for managed care organizations (MCOs), Medicaid, and commercial insurance networks. Ensure absolute compliance with specialized behavior health documentation, CPT coding standards (e.g., adaptive behavior assessment and treatment codes), and audit criteria. 7.
Provider Credentialing Alignment:
Oversee the provider credentialing process to ensure Board Certified Behavior Analysts (BCBAs) and Registered Behavior Technicians (RBTs) are linked to commercial and state panels quickly, minimizing delays in billable care.
MARGINAL FUNCTIONS
1. Collaborate closely with the Controller and CFO during month-end close to reconcile accounts receivable sub-ledgers to the general ledger. 2. Assist internal or external audit teams by providing comprehensive billing trails, revenue distribution schedules, and grant or contract utilization reports. 3. Stay continuously updated on legislative and legislative-adjacent changes affecting ABA insurance mandates, non-profit grant opportunities, and autism-funding policies.
WORKING CONDITIONS
The work is primarily within Hope's headquarters in Springfield. On occasion, the work may require travel to clinical sites or conferences. The work may require flexible hours outside of normal business hours.
KNOWLEDGE, SKILLS AND ABILITIES
1. Deep, authoritative knowledge of ABA-specific billing principles, authorization cycles, and autism-funding legislation (commercial insurance mandates and Medicaid/state-funded programs). 2. Advanced analytical mindset capable of translating complex financial, claim-level data into clear executive summaries for non-technical clinical leaders (e.g., Clinical Directors). 3. Strong leadership and boundary-setting skills to manage team dynamics, drive staff development, and advocate for operational priorities. 4. High proficiency in navigating specialized ABA EHR/billing applications (e.g., CentralReach) and integrating them cleanly with mainstream ERPs like Microsoft Business Central.
PREFERRED QUALIFICATIONS
1. Bachelor's degree in Healthcare Administration, Finance, Business Administration, or a closely related field (required); Master's degree preferred. 2. 5-8+ years of progressive experience in healthcare revenue cycle management, with at least 3 years in a dedicated supervisory capacity specifically within an ABA or behavioral health setting. 3. Professional certification in medical billing/coding or certified revenue cycle executive (CRCE) credentials a significant asset. Hope is an equal opportunity employer. #INDLP
