Director of Revenue Cycle Management

Description DIRECTOR OF REVENUE CYCLE MANAGEMENT – Chadds Ford, PA Full-Time | On-Site POSITION HIGHLIGHTS • Leadership opportunity to shape and advance revenue cycle operations within a growing healthcare organization • Opportunity to build scalable processes and drive continuous operational improvement • Strategic partnership with executive leadership and cross-functional teams • Direct impact on reimbursement performance, patient access, and organizational growth • Medical, dental, vision & 401(k) benefits • Unlimited Paid Time Off ROLE SUMMARY The Director of Revenue Cycle Management is responsible for leading, developing, and optimizing revenue cycle operations to support reimbursement performance, operational efficiency, and organizational growth.

This role oversees the teams responsible for managing commercial, federal, and contracted payer processes, including beneficiary verification, pre-determinations, authorizations, claim submission, payment resolution, audits, denial management, and appeals. This position will lead to the continued development and integration of the revenue cycle function, including the management and alignment of existing teams.

The Director will establish effective workflows, develop performance metrics, improve communication across departments, and implement processes that support scalability and long-term success. The ideal candidate is an experienced healthcare revenue cycle leader with strong knowledge of reimbursement operations, payer processes, team development, and operational improvement within a DME or healthcare environment.

KEY RESPONSIBILITIES Organizational Strategy & Revenue Cycle Leadership • Participate in company strategic planning initiatives and provide revenue cycle expertise to support organizational goals • Develop and execute revenue cycle strategies that improve reimbursement performance, operational efficiency, and scalability • Evaluate market access opportunities and communicate reimbursement considerations and business needs to Business Development leadership • Partner with Business Development leadership to build industry relationships and identify opportunities that support growth • Evaluate reimbursement opportunities for additional products, services, and future business lines • Analyze payer trends, operational performance, and reimbursement opportunities to provide recommendations to leadership Team Structure, Development & Communication • Lead, develop, and manage revenue cycle teams responsible for supporting reimbursement operations and revenue generation • Evaluate team structure, workflows, processes, and resource needs to improve operational effectiveness • Develop and implement policies, procedures, and best practices that promote efficiency, accountability, and communication • Establish key performance metrics and reporting processes to monitor productivity, workload, reimbursement performance, and operational trends • Provide coaching, development, and leadership support to team members across remote and in-office environments • Foster collaboration between Revenue Cycle, Sales, Client Services, Operations, and other departments • Identify process improvement opportunities and implement solutions that support organizational objectives Claims Management, Audits & Appeals • Oversee claim submission, error correction, payment resolution, and reimbursement optimization processes • Lead denial management strategies, including claim review, payer disputes, appeals, and resolution efforts • Oversee payer audits, claim reviews, and reimbursement documentation processes • Maintain reporting related to audit outcomes, reimbursement trends, and financial impact • Manage the Administrative Law Judge (ALJ) hearing process for Medicare RAC and prepayment audits • Identify opportunities to reduce denials, improve payment outcomes, and strengthen reimbursement performance • Ensure revenue cycle operations align with payer requirements, regulatory standards, and orga