Director of Revenue Cycle Management

POSITION SUMMARY:

The Director of Revenue Cycle Management (RCM) is responsible for overseeing all functions of the revenue cycle, including patient registration, insurance verification, coding, charge capture, billing, collections, denial management, and revenue integrity. This role ensures the organization receives timely and accurate reimbursement for services rendered while maintaining compliance with payer rules, regulations, and organizational policies. The Director provides strategic leadership, operational oversight, and process improvement to optimize revenue cycle performance. Essential Job Functions include but are not limited to those listed below.

ESSENTIAL JOB FUNCTIONS:

• Develop and execute enterprise-wide revenue cycle strategies that support the financial health and sustainability of the organization.
• Oversee all revenue cycle operations, including patient registration, insurance verification, coding, charge capture, claims submission, payment posting, A/R management, and collections.
• Lead a high-performing team of RCM directors and managers across geographically dispersed regions, fostering collaboration and accountability.
• Collaborate with clinical, compliance, IT, and finance leadership to align revenue cycle initiatives with organizational goals and patient care delivery.
• Drive process improvement initiatives to increase cash flow, reduce days in A/R, minimize denials, and improve net collections.
• Develop and manage departmental budgets, forecasts, and operational metrics to ensure financial targets are met or exceeded.
• Ensure full compliance with applicable international, federal, and state regulations and payer requirements.
• Partner with legal and compliance teams to monitor risk, maintain audit readiness, and respond to payer inquiries and audits.
• Implement and optimize technology solutions, including EHRs, billing platforms, and automation tools, to improve efficiency and data accuracy.
• Serve as a strategic advisor to executive leadership on matters related to reimbursement, payor mix, and market trends.
• Oversee training and development programs for RCM staff to maintain industry expertise and foster continuous improvement.
• Must embrace and embody the mission, vision, guiding principles, clinical vision, and goals of WestCare Foundation.
• Other relevant duties as assigned.

ESSENTIAL QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform the duties and responsibilities satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

• Strong knowledge of healthcare billing systems, coding guidelines (ICD-10, CPT), Medicare/Medicaid, commercial insurance, and reimbursement methodologies.
• Demonstrated success in driving improvements in cash collections, reducing A/R days, and minimizing denials.
• Proficiency in revenue cycle technology platforms (e.g., Epic, Cerner, Meditech, Athenahealth, etc.).
• Excellent analytical, communication, and organizational skills.
• Effective interpersonal, verbal, and written communication skills.
• Strong organizational skills with ability to prioritize and manage multiple responsibilities.
• Ability to maintain professional boundaries and exercise sound judgment in stressful situations.
• Ability to work collaboratively within interdisciplinary teams.
• Must be able to successfully obtain and maintain clearance through Nevada’s Automated Background System (NABS).
• A valid driver’s license and ability to obtain and maintain WestCare’s vehicle insurance is required.
• During your tenure with WestCare there may be new requirements, including, but not limited to vaccinations that are issued by local, State, Federal, and/or Funders that WestCare may have to comply with. Should this occur Human Resources or appropriate personnel will inform you.

EDUCATION and/or EXPERIENCE:

• Minimum of 7–10 years of progressive experience in healthcare revenue cycle management, with at least 3 years in a leadership role.
• Bachelor’s degree in healthcare administration, Business, Finance, or related field (master’s preferred).

LICENSURE/CERTIFICATION:

• Certified Revenue Cycle Professional (CRCP) or similar certification preferred.

WORKING CONDITIONS:

• Primarily office-based with occasional travel to clinical or administrative sites.
• May require extended hours to meet organizational deadlines or respond to urgent needs.