Revenue Cycle Operations Lead - Hybrid in Colorado

Job Description

Job Description

Description:

JOB SUMMARY

The Revenue Cycle Operations Lead is a hands-on role responsible for overseeing VSON’s revenue cycle workflows, coordinating with external billing partners, and ensuring accurate and efficient execution of all internal revenue cycle responsibilities.

This role is critical in a hybrid model where select functions are supported by third-party vendors while core ownership, oversight, and accountability remain within VSON. The position requires strong technical expertise, operational ownership, and the ability to identify and resolve gaps in processes while maintaining financial accuracy and continuity across all revenue cycle functions.

This is not a traditional “manager-only” role - this individual will actively engage in workflows, own outcomes, and serve as the internal subject matter expert and primary point of accountability for revenue cycle performance.

This is a full-time position, Monday through Friday from 8a - 5p with some variances. This position offers medical, dental, and vision benefits, employer-paid long-term disability and life insurance, continuing education funds, paid holidays, potential monthly bonuses and employee discounts.

This position may sit remote in Colorado, but weekly in person attendance at one of our three core locations (Edwards, Frisco, or Vail) is required.

This position is open until filled.

THE DETAILS OF THE JOB

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Maintain full visibility into revenue cycle performance including charge capture, coding coordination, claims submission, denials, and collections
• Monitor and analyze key performance indicators (AR days, denial rates, lag times, net collections)
• Identify trends, risks, and revenue leakage and implement corrective actions
• Ensure work queues (internal and vendor) are actively managed and resolved timely

• Serve as the primary operational liaison for external billing partners (e.g., Synergen, clearinghouse, workflow tools)
• Assign, monitor, and follow up on vendor work to ensure accuracy, timeliness, and accountability
• Identify gaps or inconsistencies in vendor performance and escalate appropriately
• Ensure alignment between internal workflows and vendor processes
• Participate in regular vendor meetings and performance reviews

• Oversee month-end close activities related to the revenue cycle
• Review and reconcile payments, adjustments, and accounts receivable balances
• Reconcile bank deposits, lockbox activity, and payment posting accuracy
• Identify and resolve discrepancies between billing system, clearinghouse, and bank activity
• Review suspense accounts and ensure timely resolution
• Partner with finance leadership to ensure reporting accuracy and revenue integrity

• Own and manage all revenue cycle tasks that remain internal to VSON, including:
• Charge capture accuracy and follow-up
• Coding coordination and provider communication
• Workflow management across departments impacting billing
• Partner with clinical, front desk, and ancillary teams to ensure accurate and complete information flow

• Oversee denial trends and root cause analysis
• Approve and guide appeal strategies for complex or high-value denials
• Own escalation of billing issues including denials, posting discrepancies, and payer challenges
• Ensure timely and effective AR follow-up (internal and vendor-driven)

• Establish and maintain standards for charge capture and revenue integrity
• Partner with providers and coding resources to ensure documentation quality and medical necessity
• Identify trends impacting coding accuracy and reimbursement
• Support clinical documentation improvement efforts

• Identify breakdowns in workflows and implement corrective actions
• Recommend and implement process improvements to increase efficiency and reduce revenue leakage
• Ensure alignment of workflows across departments and vendor partners

• Resolve complex patient billing issues and escalations
• Serve as the internal escalation point for revenue cycle-related concerns
• Support front desk and clinical teams with billing-related questions and process clarity

• Provide guidance and training to staff on revenue cycle processes and expectations
• Support onboarding and education across departments impacting billing
• Act as internal subject matter expert for revenue cycle operations
• Partner with leadership on reporting, performance improvement, and strategic initiatives

WHAT IT TAKES TO DO THE JOB

KNOWLEDGE, SKILLS AND ABILITIES

• Strong, hands-on experience in medical billing and revenue cycle operations (orthopedic or specialty practice preferred)
• Experience working with external billing vendors or hybrid RCM models
• Deep understanding of claims lifecycle, denials, coding coordination, and payer requirements
• Experience with financial reconciliation, reporting, and revenue cycle controls
• Ability to analyze data, identify trends, and drive process improvement
• Strong communication, organization, and problem-solving skills
• Experience with eClinicalWorks (eCW) and clearinghouse systems preferred
• Strong analytical, reporting, and problem-solving skills
• Leadership experience with ability to drive change and accountability

EDUCATION, EXPERIENCE AND CERTIFICATES

• Associates degree, preferably in business administration or related field; Bachelor degree preferred. 7+ years of medical insurance/healthcare revenue cycle experience will be considered in lieu of the degree.
• Minimum of 3 years medical insurance/healthcare billing and collections experience in a medical practice health system, with a deep understanding of medical billing rules and regulations. Orthopaedic preferred.
• Two years supervisory or management experience required
• Outstanding communication and leadership skills

NOTICE

This job description is not intended to be a comprehensive list of activities, duties or responsibilities for this job. The duties, expectations and actions listed for this role may change at any time with or without notice.

EEO STATEMENT

We believe diversity makes us stronger. Vail-Summit Orthopaedics & Neurosurgery provides equal employment opportunities to all employees and applicants without regard to sex, gender identity, sexual orientation, genetics, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.