Director of Revenue Cycle

Working under the general supervision of the Chief Financial Officer, this position provides strategic and operational leadership for InterMed’s end-to-end revenue cycle, from patient access and charge capture through billing, denials, accounts receivable, and patient financial services. The Director is accountable for accurate, compliant, and timely billing and collections that maximize net patient revenue and cash flow, and partners closely with Finance, Operations, Clinical Leadership, Compliance, IT, and Payor Contracting.

**CORE RESPONSIBILITIES:**

- Revenue Cycle Strategy & Leadership: Develops and executes the revenue cycle strategy, annual goals, policies, and performance standards in support of organizational goals. Ensures issues are resolved at their root cause rather than managed as recurring exceptions.

- Analytics & Reporting: Monitors and reports key performance indicators, including clean claim rate, denial rate, and charge and payment lag. Presents revenue cycle performance, risks, and recommendations to the Chief Financial Officer, executive leadership, and Board committees as requested.

- Accounts Receivable & Cash Performance: Owns cash collections, days in accounts receivable, net collection rate, bad debt, and credit balances. Directs action plans by payor, specialty, and location, and oversees timely resolution of refunds and unapplied cash.

- Revenue Integrity & Compliance: Provides governance over charge capture, claim edits, and the Charge Description Master, including timely CPT, HCPCS, and ICD updates. Ensures compliance with Medicare, Medicaid, commercial payor, HIPAA, and other requirements, and maintains internal controls that support audit readiness.

- Denials & Payor Performance: Leads denial prevention and resolution, including root-cause analysis and appeal strategy. Works with the Director of Payor Contracting to identify underpayments and monitor contract performance. Works with the Medical Staff Office to ensure timely provider enrollment and credentialing.

- Patient Financial Experience: Oversees eligibility, authorizations, patient estimates, statements, payment plans, financial assistance, and patient billing customer service. Partners with Operations to improve point-of-service collections.

- Technology, Budget & Vendors: Optimizes the practice management system, clearinghouse, and work queues, and leads system implementations and workflow redesign. Manages the revenue cycle budget, staffing models, and relationships with billing, clearinghouse, collection, and technology vendors.

- Collaboration & Special Projects: Supports the Controller on monthly close, net patient revenue, contractual allowances, and A/R reserves. Assesses revenue cycle readiness for new services, sites, and providers. Performs special projects as assigned.

- Leadership Competencies

- Personnel Management

- Overall accountability and management of colleagues

- Regularly assess developmental opportunities for colleagues, coach colleagues to enhance performance, and support colleagues in learning and applying new skills and competencies.

- Coordinate and monitor staffing levels and labor efficiency.

- Approver for colleague payroll biweekly in accordance with payroll department guidelines and schedule.

- Mentors and counsels’ colleagues to include initiating Performance Improvement plans.

- Works with the Compliance and Human Resources teams to ensure compliance with State, Federal and OSHA (Occupational Safety and Health Administration) requirements for colleagues.

- Leadership

- Models behaviors that demonstrate service excellence to colleagues and focus on the patient as the primary customer.

- Leads Lean Six Sigma initiatives for the department to foster a culture of continuous improvement.

- Fosters intra-departmental support and collaboration between all sites.

- Monitors department performance and creatively seeks solutions to foster quality improvement.

- Develop and maintain an open and effective line of communication with colleagues.

- Communication

- Works in partnership with the clinical teams, practice leadership, and senior leadership teams.

- Fosters strong working relationships with all levels of the organization to facilitate effective communication and to connect front line colleagues’ daily priorities to the organization’s strategic goals.

- Demonstrates strong interpersonal savvy.

- Strategic Planning and Program Coordination

- Assess current state of department with relation to existing InterMed goals and plans.

- Develops proactive plans to ensure InterMed’s position as a leader in healthcare in alignment with company KPIs.

- Monitors budgets to identify potential financial overruns and variances; makes appropriate recommendations to alleviate financial implications.

- Champions interdepartmental problem solving.

- Ensures appropriate departmental policy development and adherence.

- Confidentiality

- Demonstrate knowledge and understanding of patient privacy rights under HIPAA (Health Insurance Portability and Accountability) guidelines. Maintain confidentiality related to financial, or other sensitive materials and information in printed, electronic, or verbal form, which may jeopardize the privacy of patients and/or colleagues. Accesses and uses the minimum necessary patient identifiable information to perform job responsibilities and duties and only for authorized purposes.

- Performs other duties to support the mission, vision and values of InterMed.

**MISSION AND VALUES:**

- Follows InterMed’s mission to provide patient-centered primary care, putting the patient first to deliver high quality, high value care.

- Provide the highest quality care to our patients with a level of service that exceeds their expectations.

- Maintain a positive attitude and always treat our patients and each other with dignity and respect.

- Insist on honesty and integrity from each other and our business partners.

- Make teamwork a core component of our relationships between physicians, colleagues, and patients.

- Embrace change to better serve our patients.

- Use business practices that feature individual accountability and group responsibility to ensure delivery of high value healthcare.

- Have fun as we carry out our mission to serve.

**KNOWLEDGE, SKILLS, AND ABILITIES:**

- Education:

- Bachelor’s degree in healthcare administration, business, finance, or related field required.

- Master’s degree in a related field preferred.

- License/Certifications:

- Revenue cycle certification (e.g., HFMA CRCR or CHFP, or AAPC CPC) preferred.

- Experience:

- 7+ years of progressive healthcare revenue cycle experience, including 5+ years in leadership, required.

- Experience in a physician practice, multispecialty medical group, or ambulatory setting required.

- eClinicalWorks or comparable practice management system experience preferred.

- Strong working knowledge of professional billing, coding workflows, denial management, and Medicare, Medicaid, commercial payor, and HIPAA requirements.

- Demonstrated success improving revenue cycle metrics and cash collections using data analytics.

- The ability to manage multiple projects in a fast-paced environment.

- Effective written and verbal communication skills with individuals at all levels, including physicians and executive leadership.

- Proficiency in Microsoft Office suite is required. Advanced Excel skills are essential.

- Able to handle sensitive information and maintain confidentiality.