Full time | CST Time zone Position Summary The Director of Revenue Cycle Management - Billing & Coding leads the full billing and coding operation for Physician Practices, Rural Health Clinics (RHCs), and Hospital services. This leader owns claims accuracy, denial prevention, reimbursement performance, and A/R health across the organization, building the teams, workflows, and reporting that turn revenue cycle into a strategic advantage. The ideal candidate brings deep Medicare/Medicaid expertise, hands-on eCW and Cerner experience, and a track record of measurable improvement in cash flow and denial rates. Key Responsibilities Direct all billing, coding, claims submission, payment posting, denial management, and A/R functions for Physician Practice, RHC, and Hospital services. Lead, hire, develop, and evaluate billing and coding staff, including supervisors and specialists; set productivity and quality standards. Establish and monitor revenue cycle KPIs, including clean claim rate, denial rate, days in A/R, cash collections, and net collection rate. Oversee accurate professional (CMS-1500) and institutional (UB-04) claims submission to Medicare, Medicaid, commercial payers, and managed care organizations. Ensure coding accuracy and compliance with ICD-10-CM, CPT, HCPCS, modifier, and documentation requirements. Oversee RHC and Hospital billing and reimbursement, including cost report support and applicable Medicare and Medicaid requirements. Build and lead denial prevention and appeals strategies; analyze root causes and drive corrective action across departments. Identify underpayments and payer contract variances; partner with finance and managed care on payer performance and contract terms. Direct revenue cycle operations within eCW (Physician Practices/RHC) and Cerner (Hospital), including work queue design, system optimization, upgrades, and testing. Partner with physicians, clinical, patient access, HIM, and finance leadership to resolve documentation, charge capture, and workflow issues. Prepare and present revenue cycle performance reports, forecasts, and recommendations to executive leadership. Maintain compliance with HIPAA, CMS, payer requirements, Medicare/Medicaid regulations, and organizational policies; lead internal and external audit readiness. Develop and maintain billing and coding policies, procedures, and training programs. Lead implementation of new billing processes, regulatory changes, reimbursement models, and technology initiatives. Required Qualifications 8-10 years of healthcare billing, coding, or revenue cycle experience At least 5 years in a leadership or management role. Cerner (Oracle Health) EMR experience in a Hospital billing environment. eCW (eClinicalWorks) EMR experience. Expert knowledge of professional and hospital billing, coding, claims processing, and payer reimbursement. Extensive experience with Medicare and Medicaid billing and regulations. Proven ability to improve revenue cycle KPIs, reduce denials, and lower days in A/R. Strong leadership, analytical, and financial reporting skills. Advanced proficiency with EHR/practice management systems, revenue cycle reporting tools, and Microsoft Office (Excel in particular). Preferred Qualifications Bachelor's degree in healthcare administration, health information management, business, finance, or related field preferred. Experience leading Rural Health Clinic (RHC) billing and reimbursement. Experience leading Hospital billing operations, including critical access or community hospital settings. Experience leading multi-specialty Physician Practice revenue cycle operations. CPC, CCS, CPB, CRCR, CHFP, RHIA, or RHIT certification. Experience managing remote or multi-site revenue cycle teams. Experience with EMR conversions, system implementations, or revenue cycle vendor management. Key Competencies Revenue Cycle Leadership & Strategy Professional & Hospital Billing and Coding Expertise Physician Practice & Hospital Revenue Cycle Management Denial Prevention & Appeals Strategy Medicare/Medicaid Reimbursement KPI Management & Financial Reporting Regulatory & Compliance Oversight Team Building & Staff Development Cross-Functional Collaboration Process Improvement & Change Management Experience Revenue cycle leadership: 5 years (Required) Physician Practice billing: 5 years (Required) Hospital billing: 5 years (Required) Cerner (Oracle Health): 3 years (Required) eCW (eClinicalWorks): 2 years (Preferred)
Work Location Remote Pay:
From $85,000.00 per year
Experience:
Physician Practice Billing:
5 years (Required)
Hospital Billing :
5 years (Required)
Revenue Cycle Leadership:
5 years (Required) Cerner(Oracle Health): 1 year (Required) eCW(eClinicalWorks): 1 year (Required)
