Director of Medical Billing

Description

We are seeking a strategic and results-driven RCM Director to lead our organization's revenue cycle function end-to-end. This role owns the performance, compliance, and continuous improvement of patient access, coding, billing, collections, and denial management operations. The ideal candidate combines deep healthcare finance expertise with strong people leadership to maximize net revenue, reduce days in AR, and ensure an excellent patient financial experience.

KEY RESPONSIBILITIES

• Direct end-to-end revenue cycle operations, including patient access, eligibility/verification, charge capture, coding, claims submission, payment posting, denials, and collections
• Own and improve key RCM metrics: days in AR, clean claim rate, first-pass resolution rate, denial rate, net collection rate, and cost to collect
• Build, lead, and develop a high-performing team of RCM managers, supervisors, and staff across multiple functions and/or sites
• Partner with CFO and senior finance leadership to forecast cash flow, set revenue cycle budgets, and report on performance to the executive team and board
• Ensure compliance with CMS, payer, HIPAA, and coding/billing regulations (CPT, ICD-10, HCPCS); maintain audit readiness
• Evaluate, select, and optimize RCM technology platforms (EHR, clearinghouses, RPA/automation, analytics tools) to drive efficiency
• Lead payer contract performance analysis and collaborate with Managed Care on reimbursement issues and contract terms
• Develop and monitor policies and procedures for charity care, self-pay collections, and financial assistance in line with regulatory requirements
• Drive root-cause analysis and process improvement initiatives to reduce denials and improve first-pass claim acceptance
• Serve as the escalation point for complex billing, coding, and reimbursement issues across the organization
• Stay current on regulatory and payer policy changes (CMS, state Medicaid, commercial payers) and lead organizational readiness
• Lead system conversions, M&A integrations, and new service line onboarding as needed

BENEFITS

• Medical, dental, and vision insurance
• Paid time off and paid holidays
• Professional development and continuing education support

Requirements

REQUIRED QUALIFICATIONS

• Bachelor's degree in Healthcare Administration, Finance, Business, or related field required; Master's degree (MBA/MHA) preferred
• 10+ years of progressive experience in healthcare revenue cycle management, including 5+ years in a director-level or senior leadership role
• Deep knowledge of the full RCM value chain — registration, eligibility, coding, billing, AR, denials, and collections
• Strong understanding of Medicare, Medicaid, and commercial payer billing and reimbursement methodologies
• Proven track record managing multi-site or multi-department teams and driving measurable improvements in cash collections and AR days
• Hands-on experience with major EHR/RCM platforms (Epic, Cerner, athenahealth, Meditech, or similar)
• Strong financial acumen, including budgeting, forecasting, and P&L management
• Excellent communication and executive presence; experience presenting to C-suite and/or board members
• Working knowledge of HIPAA, CMS regulations, and healthcare compliance requirements

PREFERRED QUALIFICATIONS

• Experience in a multi-hospital health system, large physician group, or RCM services organization