Director Professional Billing Revenue Cycle

POSITION SUMMARY:

Under the direction of the Senior Director Professional Billing and Revenue Integrity, the Professional Billing Revenue Cycle Director provides strategic and operational leadership for physician billing and revenue cycle activities across the Physician Organization. This role oversees charging and billing processes, work queue management, and ensures timely and effective follow-up of outstanding claims through the third-party billing vendor. The Director is responsible for establishing organizational priorities, developing and executing operational strategies, and driving optimal performance across the physician revenue cycle. Serving as a key liaison among clinical operations leadership, third-party billing partners, vendor leadership, and internal departments, the Director fosters collaboration to enhance revenue cycle outcomes. Additionally, the Director provides leadership and direction to the Billing Senior Manager supporting physician practices, ensuring the development, implementation, and achievement of quality, performance, and compliance measures.

Position : Director, Professional Billing Revenue Cycle

Department : SS - Revenue Cycle

Schedule : Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Strategic Leadership & Supervisory Oversight: Provide strategic leadership and oversight of Billing Operations, establishing departmental priorities, performance expectations, and operational strategies while directing their Billing Senior Manager and their team to achieve short- and long-term organizational, service quality, and compliance objectives.

• Vendor & Partner Collaboration: Partner with Revenue Cycle leadership, Vendor Operations, and third-party billing vendors to optimize billing performance, maximize revenue capture, and ensure timely, accurate reimbursement.

• Process Transformation: Lead the transformation and continuous improvement of physician revenue cycle processes, driving operational efficiency, financial performance, and organizational effectiveness.

• Performance Monitoring & Analytics: Monitor revenue cycle performance through Epic dashboards, reports, and key performance indicators to proactively identify risks, barriers, and opportunities for improvement.

• Stakeholder Liaison: Serve as the primary operational liaison among physician practices, clinical leaders, third-party vendors, and Revenue Cycle departments to ensure service levels, communication, and performance objectives are met.

• Technology Governance: Oversee the implementation, optimization, and governance of revenue cycle technologies, business processes, and workflow enhancements to improve productivity, quality, and compliance.

• Financial & Trend Analysis: Develop and communicate performance metrics and financial indicators to leadership, conducting trend analysis, root cause investigations, and corrective action planning to improve financial outcomes.

• Automation & Standardization: Champion automation, system enhancements, and process standardization initiatives that streamline operations, reduce manual effort, and improve revenue cycle performance and collections.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

REQUIRED EDUCATION AND EXPERIENCE:

• Bachelor’s Degree in Business, Finance, Financial Management, Healthcare Administration, or a related field with a minimum of 10 years of related experience in healthcare revenue cycle operations; or an equivalent combination of education and experience.

PREFERRED EDUCATION AND EXPERIENCE:

• Master’s Degree in Business or Healthcare Administration with experience utilizing Epic system software.

KNOWLEDGE, SKILLS & ABILITIES (KSAs):

• Physician Revenue Cycle Expertise: Comprehensive knowledge of physician revenue cycle operations, including billing, claims management, payer reimbursement methodologies, denial management, regulatory requirements, and payment policies.

• Coding & Regulatory Knowledge: Strong understanding of CPT coding principles, payer reimbursement rules, and third-party payer regulations to ensure compliance and optimize revenue capture.

• Operational & Vendor Management: Knowledge of principles involved in managing physician revenue cycle operations, staff performance management, resource allocation, work prioritization, and third-party vendor governance.

• Advanced Analytics: Ability to interpret data, identify performance trends, perform root cause analysis, and develop actionable solutions via Epic dashboards and data models.

• Relationship Management & Communication: Ability to effectively engage, influence, and communicate with executive leadership, physician practices, operational teams, vendors, and both technical and non-technical stakeholders.

• Healthcare Technology Systems: Proficiency with healthcare technology and data systems, including Epic, nThrive, payer portals, and Microsoft Office applications (particularly Excel) for reporting and performance monitoring.

• Change Management & Process Optimization: Knowledge of change management methodologies and the ability to design policies, workflows, automation opportunities, and operational strategies that enhance efficiency and financial outcomes.

Compensation Range:

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. 

NOTE : This range is based on Boston-area data, and is subject to modification based on geographic location.

Equal Opportunity Employer/Disabled/Veterans

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