Revenue Cycle Management (US Healthcare) Director

We are seeking a highly experienced and results-oriented Revenue Cycle Management (RCM) Director to lead and optimize our revenue cycle operations. This is a strategic leadership role responsible for overseeing all aspects of the patient billing process, from pre-authorization to collections. The ideal candidate will have a proven track record of success in managing the full revenue cycle, with a particular expertise in transitioning practices from outsourced billing to an in-house model.

Responsibilities:

Provide strategic direction and leadership for the entire revenue cycle, ensuring efficient and compliant billing practices.
Develop and implement policies and procedures to optimize revenue cycle performance, focusing on areas such as coding, claims submission, denial management, and collections.
Oversee all aspects of the billing process, including charge capture, coding accuracy, clean claim submission, and timely collections.
Manage and develop the RCM team, fostering a culture of collaboration and continuous improvement.
Analyze revenue cycle data to identify areas for improvement and implement strategies to increase efficiency and cash flow.
Build and maintain strong relationships with payers and ensure timely and accurate reimbursement.
Lead the transition from outsourced billing to an in-house model (if applicable). This includes vendor management, system implementation, and staff training.
Ensure compliance with all applicable healthcare regulations (e.g., HIPAA, ICD-10).
Prepare and deliver regular reports on revenue cycle performance to senior management.

Requirements
Bachelor’s Degree in Business or Healthcare Management; or 10+ years managing the revenue cycle of a healthcare organization (may be substituted with equivalent years of experience).
Progressive experience in the health care industry; in a medical practice, health system, central billing office, or billing service; with a deep understanding of medical billing rules and regulations.
Strong working knowledge of CPT and ICD10 codes, HIPAA, HCFA/UB-04 claims, medical terminology, insurance regulations, insurance benefits and appeal processes.
Proven ability to perform strategic planning and priority setting for a billing department.
Proven track record for improving process efficiencies and problem solving.
Strong leadership skills with an ability to motivate direct reports.
Detail oriented with excellent communication skills both written and verbal, and interpersonal skills.
Intuitive, with excellent analytical and critical thinking skills. Strong research and auditing skills.
Expert in Microsoft Office, including Outlook, Word, Excel and Power Point.
Out of Network billing experience a plus.
Emergency Services billing experience a plus.
Experience working with healthcare systems: EPowerDoc, GoREV, Waystar, Availity and payer sites.
Certificate in Coding is a plus

Benefits
Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.

Permanent Work From home
Full-time position – 40hrs/wk
Permanent Weekends Off
Great Company Culture and No Micromanagement

Who We Are

MedCore Solutions is an industry leader in staff augmentation company with a global presence focused on placing highly skilled employees in hospitals and medical facilities. We are committed to delivering the best results for our clients and we ensure a rewarding, respectful, and productive experience for our employees.

Physicians and hospital practice managers understand how difficult it can be to place high-quality service providers at every level of their practice. HR requirements, retention, high turnover, onboarding processes, and training are just some of the challenges that face our healthcare system every day.

We understand the challenges that healthcare professionals face when it comes to hiring, training, and retaining talent. We integrate healthcare professionals into your existing ecosystem and handle these so you don’t have to.