We are looking for a dedicated Revenue Cycle Management Director to lead and manage all aspects of our client's revenue cycle operations. This position plays a critical role in optimizing billing, coding, claims processing, insurance verification, and collections to ensure compliance and maximize reimbursement. The ideal candidate will bring strategic leadership and collaboration skills to support equitable healthcare access and operational efficiency. Responsibilities:• Oversee the revenue cycle processes for Medicaid, Medicare, managed care, commercial payers, and sliding fee programs.• Establish and enforce billing policies that align with regulatory requirements and organizational guidelines.• Manage provider and facility credentialing processes to ensure timely enrollment with insurance payers.• Monitor and analyze key performance indicators, accounts receivable data, and reimbursement trends to identify and implement performance improvements.• Handle payer contracts, denial management, and appeals to ensure accurate and timely resolutions.• Collaborate with departments such as operations, finance, and quality to enhance workflows and support population health goals.• Ensure accurate medical, dental, behavioral health, and vision coding and claims submissions.• Provide strategic direction, foster staff development, and oversee performance management within the revenue cycle team.• Lead initiatives to improve compliance and efficiency across the revenue cycle.• Drive continuous improvement in revenue cycle operations by leveraging data insights and industry best practices.

• Bachelor’s degree in Business, Finance, Healthcare Administration, or a related field; a Master’s degree is preferred.• 7+ years of experience in healthcare revenue cycle management, including experience in a leadership role.• Certification in healthcare revenue cycle management or a related field is required.• Strong expertise in billing, coding, payer compliance, and revenue cycle systems.• Knowledge of Medicaid, Medicare, and commercial payer processes.• Excellent leadership and communication skills to manage teams and collaborate across departments.

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Carlisle, PA
onsite
Permanent
90000.00 - 110000.00 USD / Yearly
We are looking for a dedicated Revenue Cycle Management Director to lead and manage all aspects of our client's revenue cycle operations. This position plays a critical role in optimizing billing, coding, claims processing, insurance verification, and collections to ensure compliance and maximize reimbursement. The ideal candidate will bring strategic leadership and collaboration skills to support equitable healthcare access and operational efficiency. Responsibilities:• Oversee the revenue cycle processes for Medicaid, Medicare, managed care, commercial payers, and sliding fee programs.• Establish and enforce billing policies that align with regulatory requirements and organizational guidelines.• Manage provider and facility credentialing processes to ensure timely enrollment with insurance payers.• Monitor and analyze key performance indicators, accounts receivable data, and reimbursement trends to identify and implement performance improvements.• Handle payer contracts, denial management, and appeals to ensure accurate and timely resolutions.• Collaborate with departments such as operations, finance, and quality to enhance workflows and support population health goals.• Ensure accurate medical, dental, behavioral health, and vision coding and claims submissions.• Provide strategic direction, foster staff development, and oversee performance management within the revenue cycle team.• Lead initiatives to improve compliance and efficiency across the revenue cycle.• Drive continuous improvement in revenue cycle operations by leveraging data insights and industry best practices.
2025-11-20T01:13:45Z

Revenue Cycle Director Job in Carlisle | Robert Half