Executive Director Revenue Cycle

Job Specific Duties

Lead and optimize all components of the revenue cycle, including:
Patient access (scheduling, registration, authorization, financial counseling)
Case Management, Social Work, Pastoral Services, and Transfer Center
Health information management (HIM), coding and CDI
Revenue integrity, Charge Description Master (CDM), charge capture, and billing
Patient financial services, A/R follow up, Appeals and Underpayments, Cash/Credit Management, and Customer Service
Ensure seamless coordination across all functions to achieve timely and accurate revenue capture and reimbursement.
Lead governance and performance management of the organization’s outsourced revenue cycle vendor(s), inlcluding:
Establishing and enforcing SLAs tied to key KPIs (e.g., net collection rate, AR days, denial rate)
Conducting regular business and performance scorecard reviews
Driving continuous improvement and corrective action plans for underperformance
Partnering on optimization initiatives (automation, AI, workflow redesign)
Oversee contract performance, escalation management, and alignment of vendor operations with system goals.
Oversee key revenue cycle metrics, including, but not limited to:
Days in AR-
Denial rates-
Net collection rate, including complex large balance claims-
Bad debt performance-
Excess/Avoidable Days
Coding accuracy
Point of Service Collections
Call Center and Pre-Access Metrics: Speed to Answer, Accuracy, Authorization Days Out, etc.
Patient Financial Experience
Develop and maintain a structured performance reporting framework and accountability forums.
Analyze trends and implement targeted initiatives to improve financial outcomes.
Partner with leadership and vendor partners to define and execute a multi-year revenue cycle strategy:
Technology optimization (e.g., EMR revenue cycle platforms, automation, analytics tools)
Shared services and operating model design
Integration of vendor and internal workflows
Collaborate with IT teams and vendors to identify system enhancements and ensure alignment with business needs.
Ensure adherence to all regulatory, payer, and compliance requirements (IRS, OIG, CMS, HIPAA, payer contracts).
Mitigate financial risk through strong internal controls and processes.
Lead and develop a high-performing revenue cycle organization, including internal leaders and vendor teams.
Establish clear accountability structures, performance expectations, and training programs.
Foster a culture of continuous improvement, collaboration, and service excellence.
Demonstrate strong communication and collaboration skills across the enterprise.
Partner with clinical and operational leaders to enhance transparency and the overall patient financial experience.
Ensure patient-friendly billing practices and effective patient financial assistance programs.
Qualifications

Minimum Job Requirements

Bachelor’s Degree in Business or Healthcare Administration
7-10 years of progressive experience in the healthcare revenue cycle
Healthcare industry financial statistical indicators experience
Knowledge, Skills, and Abilities

Master’s degree preferred.
HFMA, AAHAM, or similar professional certification preferred.
Epic experience preferred.
Florida Medicaid experience preferred.
Proven ability to lead large-scale operational and transformation initiatives.
Deep understanding of end-to-end revenue cycle processes, including, billing, coding, reimbursement, and denial management.
Strong leadership and communication skills.
Experience in negotiating contracts and resolving vendor/service issues.
Demonstrated experience managing outsourced revenue cycle vendors or shared services models.
Knowledge of healthcare regulatory requirements and payer dynamics.