Director Operations ( Revenue Cycle Management)

Overview The Director Operations (RCM) is responsible for leading end-to-end revenue cycle operations with a strong focus on billing, prior authorization, denials, and appeals management. This role ensures operational performance, regulatory compliance, and delivery against client and organizational objectives. The Operations Manager oversees large-scale teams, manages inventory and workflow, and implements strategies to improve collections, reduce denials, and optimize revenue outcomes. This position requires a deep understanding of billing systems, payer requirements, and denial management processes, while driving cross-functional collaboration and continuous improvement. Performs other duties as assigned. Responsibilities Lead and oversee daily operations across billing, eligibility, prior authorization, denials,appeals, AR follow-up, and payment posting functions Manage and develop large teams (100+ FTEs), including direct supervision, coaching,performance management, and employee development Direct denials management operations, including research, appeals, reimbursement analysis, and follow-up on pending claims Ensure timely, accurate submission of claims and resolution of accounts to maximize reimbursement and minimize denials Analyze reimbursement trends, payer behavior, and denial patterns to drive corrective actions and improve outcomes Oversee inventory management, workload distribution, and prioritization to ensure timely execution and reduce aging risk Collaborate with cross-functional teams (HR, IT, Compliance, Quality, Training) to support operational initiatives and process improvements Act as a liaison across departments to ensure alignment, communication, and execution of revenue cycle initiatives Monitor adherence to policies, procedures, and compliance requirements, including auditing and quality assurance activities Provide reporting and insights to leadership and clients, including operational performance, KPIs, and improvement plans Lead Monthly Business Reviews (MBRs) and support client-facing discussions Support hiring, onboarding, training, and ongoing development of team members Foster a high-performance culture focused on accountability, engagement, and retention Ensure proper payer setup, eligibility validation, and billing system accuracy Maintain confidentiality and ensure proper handling of Protected Health Information (PHI)

Qualifications & Requirements:

Bachelor's degree required (or equivalent experience) 8+ years of experience in end-to-end Revenue Cycle Management (RCM) Minimum 3+ years of leadership experience in a high-volume billing or denials management environment Experience managing large teams (100+ FTEs) in fast-paced operations Laboratory billing experience preferred

Technical & Functional Expertise:

Strong knowledge of reimbursement, billing, coding, and healthcare compliance regulations Deep understanding of payer eligibility, benefits, and denial management processes Experience with billing systems and revenue cycle platforms Proficiency in Microsoft Office Suite, particularly Excel and PowerPoint Ability to perform complex data analysis and present findings to leadership

Pay:

$80,000.00 - $100,000.00 per year

Benefits:

401(k) Dental insurance Health insurance Paid time off Retirement plan Vision insurance

Work Location:

In person