Position Summary

The Senior Director of Revenue Cycle provides strategic oversight, leadership, and operational performance management across all revenue cycle functions. This role ensures optimal financial outcomes, operational efficiency, and compliance with regulatory requirements while enhancing patient access, billing, collections, coding accuracy, and reimbursement. The Senior Director collaborates with clinical, financial, and operational leaders to drive process improvements, strengthen revenue integrity, and improve the patient financial experience.

 

Key Responsibilities

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Strategic Leadership & Revenue Optimization

• Develop and execute revenue cycle strategies to maximize reimbursement and improve financial performance.

• Establish KPIs and best practices to enhance efficiency, cash flow, and patient experience.

• Lead front-end (Access Care), mid-cycle (HIM & Coding), and back-end (Billing & Collections) operations.

• Ensure compliance with industry regulations, payer requirements, and hospital standards.

Access Care Management

• Oversee patient access functions including registration, scheduling, insurance verification, and financial counseling.

• Implement process improvements to ensure accurate patient data collection and upfront revenue capture.

• Enhance patient experience through streamlined financial clearance and eligibility verification.

Health Information Management (HIM) & Coding

• Direct HIM and Coding operations to ensure accurate, compliant documentation and coding.

• Collaborate with physicians and clinical teams to improve documentation quality and coding accuracy.

• Ensure compliance with ICD-10, CPT, HCPCS, and regulatory changes.

• Lead CDI initiatives to maximize reimbursement and reduce denials.

Charge Description Master (CDM) & Charge Capture

• Maintain accuracy and integrity of the CDM in alignment with pricing, coding, and billing practices.

• Implement reconciliation and auditing processes to prevent lost charges and revenue leakage.

• Update CDM regularly to reflect industry changes and reimbursement guidelines.

Business Office Oversight

• Lead billing, collections, and AR management to optimize net revenue.

• Implement strategies to reduce denials, accelerate collections, and improve reimbursement accuracy.

• Oversee revenue cycle analytics, forecasting, and financial reporting for leadership decision-making.

Vendor Management & Payer Relations

• Manage third-party vendor relationships and negotiate contracts for cost-effective service delivery.

• Collaborate with payer contracting teams to improve reimbursement rates and resolve disputes.

• Ensure compliance with payer contracts and optimize vendor performance.

 

Reports To

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Chief Financial Officer (CFO)

 

Supervises

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Access Care, Charge Description Master (CDM) & Charge Capture, Business Office, Vendor Management, Health Information Management (HIM), and Coding teams.

 

Qualifications

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• Minimum 10 years of progressive hospital revenue cycle management experience, including HIM and Coding oversight.

• Proven leadership in acute care settings with a track record of driving revenue cycle improvements.

• Extensive knowledge of hospital billing, coding (ICD-10, CPT, HCPCS), compliance, and payer reimbursement.

• Strong analytical, problem-solving, and financial acumen.

• Experience with revenue cycle technology platforms and automation tools.

 

Key Competencies

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• Strategic Vision: Ability to align revenue cycle strategies with hospital objectives.

• Operational Excellence: Deep understanding of revenue cycle, HIM, and coding best practices.

• Leadership & Collaboration: Skilled at leading high-performing teams and fostering cross-departmental partnerships.

• Regulatory Compliance: Expertise in HIPAA, CMS, Medicare, Medicaid, and commercial payer guidelines.

• Technology & Analytics: Ability to leverage AI, automation, and predictive analytics to improve performance.

 

Education

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• Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or related field required.

• Advanced degree or professional certifications (e.g., HFMA, CHFP, CRCE) preferred.