Director of Revenue Cycle

Director of Revenue Cycle Confidential Iselin, NJ Job Details Full-time $100,000 - $125,000 a year 2 hours ago Qualifications Revenue cycle management Management Insurance verification Certified Professional Biller (CPB) Team leadership Medical coding Practice management software Metrics Reporting Supervising experience Leading team collaboration initiatives Medical accounts receivable management Medical claim denial management Financial data analysis tools Full Job Description The Director of Revenue Cycle is responsible for the strategic oversight, performance management, and optimization of the medical group's revenue cycle operations . This role leads the billing team, monitors key revenue cycle performance indicators, drives process improvement, ensures payer compliance, and maximizes reimbursement while maintaining high standards of accuracy, efficiency, and patient service. Key Responsibilities Revenue Cycle Leadership & Oversight Direct and oversee daily operations of the billing department, including charge capture, claim submission, payment posting, denial management, and patient billing. Supervise and mentor billing staff; establish clear expectations, productivity standards, and performance goals. Responsible for provider credentialing process in coordination with RWJ for onboarding/offboarding, document collection, completing applications, checking statuses, and providing monthly updates. Develop and maintain standardized workflows and ensure consistent execution across all billing functions. Ensure compliance with federal, state, payer, and organizational billing regulations and policies. Serve as the primary escalation point for complex billing, payer, and patient account issues. Analytics, Reporting & KPI Ownership Own and monitor the financial health of the revenue cycle through data-driven analysis. Key Metrics to Monitor Net collection rate Days in Accounts Receivable (DAR) Aging >90 and >120 days Denial rate and denial categories Clean claim rate / first-pass resolution rate Charge lag and payment lag. Credit balance trends. Productivity metrics per FTE Responsibilities Produce and present monthly revenue cycle performance reports to leadership. Identify trends, root causes, and opportunities for improvement. Implement corrective action plans when KPIs fall below targets. Use reporting tools and dashboards to monitor payer performance and reimbursement accuracy. Provide financial impact analysis of workflow or payer changes. Team Management & Staff Development Recruit, train, coach, and evaluate billing staff. Conduct regular performance reviews and productivity monitoring. Establish team productivity benchmarks and quality standards. Identify skill gaps and coordinate ongoing training and development. Foster a culture of accountability, collaboration, and continuous improvement. Denial Prevention & Payer Management Oversee denial management strategy and ensure timely follow-up. Analyze denial trends and implement preventive workflow changes. Monitor payer reimbursement patterns and escalate underpayment issues. Coordinate with credentialing, coding, and clinical teams to resolve systemic issues. Participate in payer meetings and contract performance discussions when applicable. Process Improvement & Workflow Optimization Evaluate and redesign workflows to increase efficiency and reduce rework. Lead revenue cycle improvement initiatives and projects. Implement automation and technology solutions when appropriate. Maintain and update billing policies and procedure documentation. Ensure effective coordination between front desk, clinical, coding, and billing teams. Compliance & Quality Assurance Ensure billing practices meet regulatory and payer requirements. Oversee internal audits of billing accuracy and documentation. Maintain HIPAA compliance and data security standards. Support external audits and respond to payer requests. Patient Financial Experience Oversee patient billing and statement processes. Ensure timely and professional resolution of patient billing inquiries. Collaborate on financial policies and patient payment programs. Required Qualifications 5+ years of medical billing/revenue cycle experience. 2+ years of supervisory or management experience. Strong knowledge of medical billing, coding, payer rules, and EOB/ERA processing. Experience with practice management and billing systems. Advanced proficiency in reporting and Excel/data analysis. Strong leadership, communication, and problem-solving skills. Preferred Qualifications Certified Professional Biller (CPB), CPC, or similar certification. Experience managing revenue cycle KPIs and dashboards. Experience with payer contract analysis or underpayment review. Success Measures (First 12 Months) A successful Director of Revenue Cycle will: Improve key revenue cycle KPIs. Reduce A/R aging and denial rates. Increase staff productivity and accountability. Implement measurable workflow improvements. Provide consistent, actionable reporting to leadership.

Pay:

$100,000.00 - $125,000.00 per year

Work Location:

In person