Director of Revenue Cycle

Job Title:  Director of Revenue Cycle  

Location:  ReVive Orthopedics Spine & Sports Medicine 
Type:  Full-Time-Exempt 

Reports to: CFO 

Position Summary 

The Revenue Cycle Director is responsible for the strategic leadership, operational management, and performance optimization of the full revenue cycle for a growing orthopedic practice and ambulatory surgery center (ASC). This role oversees both commercial insurance, workman’s comp, and personal injury accounts to include coding, billing, collections, reimbursement, denial management, appeals, and revenue integrity functions to maximize cash collections, improve operational efficiency, and ensure compliance with all regulatory and payer requirements. 

The Director will lead a growing team of revenue cycle professionals through two direct-report managers/supervisors and serve as a key partner to executive leadership in driving financial performance through data analysis, reporting, and payer collaboration. 

Key Responsibilities 

Revenue Cycle Operations 

• Direct and oversee all revenue cycle functions including:  

• Coding  

• Charge capture  

• Billing  

• Claims submission  

• Payment posting  

• Collections  

• Denials management  

• Appeals management  

• Reimbursement optimization  

• Personal Injury account management 

• Ensure timely and accurate claims processing and reimbursement across all payers.  

• Oversee accounts for receivable management with a focus on reducing Days in A/R and improving cash collections.  

• Develop and implement revenue cycle workflows, policies, and best practices to improve efficiency and scalability.  

Financial & Operational Analytics 

• Analyze claims, reimbursement, payer mix, and collection of trends to identify opportunities for revenue enhancement.  

• Monitor and report on key performance indicators including:  

• Net Collection Rate  

• Gross Collection Rate  

• Days in A/R  

• Denial Rate  

• Clean Claim Rate  

• Aging Buckets  

• Lag Days  

• Build, maintain, and present executive revenue cycle dashboards to leadership.  

• Evaluate service line profitability and reimbursement performance across orthopedic and ASC offerings.  

• Provide strategic recommendations to improve margin, reimbursement, and operational efficiency.  

Compliance & Revenue Integrity 

• Ensure coding and billing compliance with federal, state, payer, and specialty-specific regulations.  

• Maintain oversight of documentation, coding accuracy, audit readiness, and reimbursement integrity.  

• Partner with compliance and clinical leadership on coding education and audit initiatives.  

Payer Relations / Contracting Support 

• Interface directly with commercial payers, attorneys, workers’ compensation carriers, and personal injury representatives regarding claims, reimbursement disputes, escalations, and operational issues.  

• Support payer contracting and reimbursement strategy through claims and reimbursement analytics.  

• Identify underpayments and reimbursement of variance opportunities.  

Leadership & Team Development 

• Lead, mentor, and develop direct reports and an overall team.  

• Establish accountability of metrics and performance standards for staff and management. 

•  Drive a culture of continuous improvement, operational excellence, and service. 

Qualifications 

• Bachelor's degree in healthcare administration, Finance, Business, or related field required; master's degree preferred.  

• 7+ years of progressive revenue cycle leadership experience in physician practice and/or ASC settings.  

• Orthopedic practice revenue cycle experience strongly preferred.  

• Demonstrated expertise in:  

• Professional and facility coding/billing  

• Claims reimbursement  

• Denials and appeals  

• Accounts receivable management  

• Revenue cycle analytics  

• Strong working knowledge of:  

• Personal Injury (PI) billing/workflows  

• Workers’ Compensation (WC) billing/workflows  

• Experience with Athenahealth and SIS (Surgical Information Systems) a plus.  

• Deep understanding of payer reimbursement methodologies and managed care operations.  

• Strong analytical, financial modeling, and dashboard/reporting capabilities.  

• Proven leadership experience managing managers/supervisors and larger operational teams. 

Preferred Certifications  

CPC, CCS, CPMA, CRCR, HFMA, or other relevant revenue cycle/coding certifications preferred. 

Key Competencies 

• Strategic Financial Acumen  

• Revenue Optimization  

• Operational Excellence  

• Data-Driven Decision Making  

• Team Leadership & Development  

• Payer Negotiation Support  

• Process Improvement / Lean Thinking  

• Executive Communication / Presentation Skills 

• Personal Injury Experience 

Success Metrics 

Performance in this role will be measured by improvements in: 

• Net Collection Rate  

• Days in Accounts Receivable  

• Denial Rate / Appeal Success Rate  

• Underpayment Recovery  

• Coding Accuracy / Audit Scores  

• Service Line Margin Performance  

• Team Productivity / KPI Achievement 

Why Join Us? 

ReVive Orthopedics Spine & Sports Medicine offers a collaborative environment focused on patient care excellence and professional growth. We provide a competitive benefits package, including: 

• Medical Insurance 

• Vision and Dental Insurance 

• 401(k) Retirement Plan 

• Paid Time Off and Holidays 

• Mileage Reimbursement for travel to satellite offices  

• Compensatory Bonuses based on productivity and performance
• Competitive Pay:  110K-130K/yearly depending on qualifications and experience.

Join our team and contribute to a positive, patient-centered experience in orthopedic healthcare. 

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