Director of Revenue Cycle

Director Of Revenue Cycle

Bradford Health Services provides addiction treatment programs, resources, and community for every aspect of recovery. Through our premier drug and alcohol rehab facilities across the Southeast, we provide affordable, evidence-based addiction treatment with proven outcomes at every level of care. We're guided by unity and dedicated to meeting and treating every patient right where they are. Bradford is more than a healthcare network; we are recovery communities for every stage of the journey.

We are seeking a Director of Revenue Cycle to add to our dynamic team. The Director of Revenue Cycle Operations leads the daily operations and ongoing transformation of billing, accounts receivable, payment posting, cash reconciliation, credit balance, and related revenue cycle functions across a complex, multi-state behavioral healthcare organization. Reporting to the Vice President of Revenue Cycle, the Director is accountable for timely and accurate claim submission, effective payer follow-up, accurate payment and adjustment posting, disciplined account resolution, and measurable improvement in cash, aging, quality, and productivity.

This is a hands-on operational leadership role. The Director must understand the detailed mechanics of claims, work queues, clearinghouse transactions, payer edits, remittances, denials, adjustments, unapplied cash, refunds, and account documentation. The leader will personally analyze workflows and representative accounts when needed, establish standardized processes and desk-level procedures, design an effective organizational structure, identify system limitations and configuration opportunities, and evaluate responsible uses of automation and artificial intelligence. The role partners with Centralized Admissions Department, Patient Financial Services, Utilization Review, Clinical Operations, Finance, Information Technology, Compliance, and external vendors while maintaining clear ownership of back-end revenue cycle execution.

Responsibilities

• Provide direct operational leadership for billing, accounts receivable follow-up, payment posting, cash reconciliation, credit balances, refunds, and related back-end revenue cycle functions
• Maintain detailed knowledge of daily inventory, work queues, claim status, billing holds, clearinghouse rejections, payer responses, payment exceptions, aged accounts, and unresolved operational barriers
• Conduct detailed reviews of workflows and representative patient accounts to determine what occurred, what should have occurred, and what corrective action is required
• Design and standardize end-to-end workflows from charge release and claim creation through payment, follow-up, adjustment, refund, and final account resolution
• Establish clear ownership, handoffs, service-level expectations, escalation pathways, and quality controls for every major billing, accounts receivable, and payment-posting workflow
• Oversee claim generation, claim-edit resolution, clearinghouse submission, payer acceptance, rejection correction, and timely filing controls
• Develop payer-specific accounts receivable strategies using age, balance, payer, denial reason, filing limit, reimbursement risk, and probability of collection to prioritize work
• Establish standards for follow-up frequency, account documentation, next-action dates, escalation, appeal, write-off review, and final disposition
• Oversee accurate ERA and manual payment posting, contractual and non-contractual adjustments, denial posting, recoupments, takebacks, unapplied cash, deposits, refunds, and daily and monthly reconciliation
• Create controls that ensure posted cash and adjustments reconcile to bank deposits, remittance files, general ledger activity, and expected payer reimbursement
• Develop and maintain standard operating procedures, desk-level instructions, workflow maps, training materials, audit tools, and change-control processes
• Establish daily, weekly, and monthly productivity, quality, timeliness, and inventory standards by function and role
• Build dashboards and operating reviews that translate revenue cycle data into clear actions, owners, deadlines, and measurable outcomes
• Design the billing, accounts receivable, and payment operation's organizational structure based on actual workload, transaction volumes, skill requirements, span of control, and future growth
• Assess staffing needs, role clarity, management layers, workload distribution, cross-training, coverage plans, and opportunities to consolidate or specialize work
• Develop leaders and front-line team members through clear expectations, coaching, training, quality feedback, performance management, and succession planning
• Identify process failures, system limitations, configuration issues, interface gaps, duplicate work, and manual workarounds that create delay, error, or unnecessary cost
• Partner with Information Technology, system vendors, and operational stakeholders to define requirements, test changes, validate outcomes, and sustain improvements
• Evaluate automation and artificial intelligence opportunities using clear business cases, expected return, workflow impact, data quality, privacy, compliance, and human oversight requirements
• Prioritize process correction and standardization before automating unstable or poorly controlled workflows
• Lead backlog reduction, system remediation, payer-specific improvement initiatives, and other focused recovery efforts while protecting current production
• Partner with Patient Access and Utilization Review leaders to resolve upstream issues affecting claim quality or reimbursement without assuming operational ownership of those functions
• Collaborate with Finance on cash reporting, month-end close, reserves, write-offs, refunds, reconciliation, and financial reporting accuracy
• Maintain compliance with HIPAA, 42 CFR Part 2, payer contracts, governmental requirements, internal controls, and organizational policies
• Perform other duties assigned in support of Revenue Cycle and organizational objectives.

Qualifications

• Bachelor's degree in healthcare administration, business, finance, accounting, health information management, or a related field, or an equivalent combination of education and directly relevant leadership experience
• Minimum 10 years of progressive healthcare revenue cycle experience, including at least 5 years leading billing, accounts receivable, payment posting, or closely related back-end revenue cycle operations
• Demonstrated expert-level knowledge of the day-to-day mechanics of claim generation and submission, claim edits and rejections, payer follow-up, denial resolution, remittance processing, contractual adjustments, cash reconciliation, credit balances, refunds, and final account resolution
• Demonstrated experience personally reviewing claims, work queues, remittances, account notes, system transactions, and workflow exceptions to identify root causes and verify operational performance
• Demonstrated experience building, centralizing, restructuring, or materially improving healthcare billing, accounts receivable, or payment operations
• Experience developing standard operating procedures, desk-level workflows, role definitions, productivity expectations, quality audits, performance dashboards, and escalation pathways
• Experience designing staffing models and organizational structures using inventory, transaction volumes, payer mix, complexity, service-level expectations, and productivity assumptions
• Experience identifying system limitations, configuration gaps, manual workarounds, and opportunities for workflow automation
• Strong analytical ability with experience using revenue cycle data to diagnose operational problems and drive corrective action
• Proven ability to lead managers and front-line teams through change while maintaining daily production, quality, accountability, and staff engagement
• Working knowledge of HIPAA, 42 CFR Part 2, payer requirements, and applicable federal and state billing and collection requirements

Preferred Qualifications

• Master's degree in healthcare administration, business administration, finance, or a related field
• Behavioral health and substance use disorder revenue cycle experience, including residential, inpatient, partial hospitalization, intensive outpatient, and outpatient services
• Experience within a multi-site and multi-state healthcare organization with centralized revenue cycle operations
• Experience with commercial insurance, Medicare, Medicaid, Managed Medicaid, TRICARE, Veterans Affairs, and other government or managed-care payers
• Experience optimizing an electronic health record, practice management system, clearinghouse, payer portal, banking platform, or revenue cycle work queue solution
• Experience evaluating or implementing automation, robotic process automation, machine learning, or artificial intelligence solutions within revenue cycle operations
• Experience with system conversions, mergers, acquisitions, integrations, or rapid organizational growth
• Professional certification such as CHFP, CRCR, HFMA certification, or an equivalent revenue cycle credential

At Bradford Health Services, we are committed to providing exceptional care to our patients while fostering a supportive and rewarding workplace for our employees. We believe that taking care of our team allows them to take better care of others, which is why we offer a comprehensive benefits package designed to support their well-being.

• Medical Coverage Three new BCBSAL medical plans with better rates, improved co-pays, and enhanced prescription benefits.
• Expanded Coverage Options for domestic partners and a wider network of in-network providers.
• Mental Health Support Improved access to services and a new Employee Assistance Program (EAP) featuring digital