- Senior
- Oficina en Opelousas
The Director of Revenue Cycle Operations is the senior leader responsible for the strategy, governance, and execution of end-to-end revenue cycle functions across the organization. This role oversees patient access, charge capture, billing, collections, payer relations, and vendor management to optimize net revenue, accelerate cash flow, ensure regulatory compliance, and deliver an excellent patient financial experience. The Director partners closely with executive leadership, clinical service lines, and IT to align revenue cycle performance with organizational goals.
Essential Duties & Responsibilities
Strategy & Leadership
Oversees internal teams and external vendors (early-out, bad debt, eligibility/coverage discovery, RPA/automation, and clearinghouse partners).
- Develop and execute a revenue cycle strategy aligned with system growth, payer mix, and operating margin targets.
- Establish governance structures, policies, and standard work to ensure consistency and scalability.
- Serve as executive sponsor for major initiatives (EHR/billing modernization, automation, price transparency, patient financing programs).
Operational Excellence
- Own end-to-end processes from scheduling/registration and insurance verification through charge capture, claim submission, payment posting, follow-up, denials, and self-pay collections.
- Drive standardization, Lean/Six Sigma continuous improvement, and automation (RPA, rules engines, work queues) to reduce cost-to-collect and rework.
- Ensure accurate charge description master (CDM) maintenance and revenue integrity controls in collaboration with clinical and finance leaders.
Payer Strategy & Contracting Support
- Partner with Managed Care/Contracting to operationalize payer terms, monitor payer compliance, and escalate chronic underpayments.
- Lead enterprise denials prevention and appeals strategy, including root-cause analytics and corrective action with service lines.
Technology, Data & Analytics
- Define the revenue cycle technology roadmap in partnership with IT (EHR, billing, clearinghouse, eligibility, estimation, digital patient financial tools).
- Build robust dashboards and self-service analytics for executives and operators; institute data governance and KPI definitions.
Compliance, Risk & Controls
- Maintain compliance with federal/state regulations (e.g., CMS, HIPAA, price transparency, No Surprises Act, charity care/financial assistance policies), payer requirements, and internal control frameworks.
- Oversee audit readiness (internal/external), integrity monitoring, and corrective action plans.
Patient Financial Experience
- Advance upfront financial counseling, price estimates, digital payment options, compassionate collection practices, and clear communications to improve patient satisfaction and equity.
- Ensure consistent application of financial assistance policies and adherence to fair billing practices.
Talent & Culture
- Recruit, develop, and retain high-performing leaders; set clear expectations and succession plans.
- Foster a culture of accountability, inclusion, transparency, and continuous learning.
Cross-Functional Collaboration
- Partner with Finance, Compliance, IT, Supply Chain, Case Management/Utilization Review, and clinical leadership to align documentation, utilization, and billing practices with reimbursement policies.
Qualifications
Education:
- Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required.
- Master’s degree (MHA, MBA, MPH or related) strongly preferred.
Experience:
- 10+ years of progressive leadership in hospital or health system revenue cycle, including 5+ years as a Director
- Demonstrated success leading large teams, and complex change initiatives (EHR conversions, centralization, automation).
- Proven track record partnering with managed care, IT, and clinical leaders to improve yield and reduce denials.
