Director of Revenue Cycle Management

Director of Revenue Cycle Management

The Director of Revenue Cycle Management provides organizational leadership and oversight of VOA Alaska's revenue cycle management, Medicaid and payer billing compliance, and agency-wide quality assurance systems. This position is accountable for ensuring compliance with Alaska Division of Behavioral Health (DBH) regulations, Medicaid requirements, and payer standards while optimizing appropriate reimbursement for services rendered.

The Director provides leadership of the development and execution the agency's revenue cycle strategy, aligning billing operations, billing integrity, documentation quality, audit readiness, and regulatory compliance across all programs. This role directly supervises the Client Care Supervisor, Billing Team, and provides consultation to Quality Assurance. Additionally, the Director works in close partnership with the Compliance & Risk Manager to identify, mitigate, and manage regulatory, billing, and documentation risk across the organization.

Job Responsibilities

• Provide strategic and operational oversight of behavioral health billing, collections, and accounts receivable functions to ensure timely, accurate reimbursement.
• Ensure accurate and timely billing to Medicaid, commercial insurance, and agency payers (including DJJ, OCS, and IHS), prioritizing cash flow and revenue integrity.
• Oversee revenue cycle performance, including claims submission, denials, appeals, recoupments, refunds, and aging AR trends.
• Monitor federal and state procedural and diagnostic coding updates and ensure EHR configuration and billing workflows remain current.
• Ensure effective front-end revenue cycle processes with oversight of the Client Care Team, including payer eligibility verification, authorization management, benefits coordination, and service authorization compliance to reduce denials and support timely reimbursement.
• Ensure agency-wide compliance with Alaska Division of Behavioral Health regulations, Medicaid requirements, and payer standards.
• Partner with Quality Assurance Team, providing consultation and maintaining executive oversight of documentation integrity, medical necessity, and golden thread alignment to support compliant and defensible billing.
• Partner closely with the Compliance & Risk Manager to identify billing and documentation risk, respond to audits, and implement corrective actions.
• Collaborate with Finance to forecast revenue, monitor reimbursement trends, evaluate financial risks, and support organizational budgeting and financial planning activities.
• Participate in optimization of EHR, billing, clearinghouse, and revenue cycle technologies to improve workflow efficiency, data integrity, claim accuracy, and reimbursement outcomes.
• Oversee payer contract negotiations, reimbursement rates, and single case agreements to support financial sustainability.
• Translate audit findings, regulatory changes, and revenue data into system improvements, staff training priorities, and continuous quality improvement.
• Develop, monitor, and report key revenue cycle performance indicators such as Days in A/R, clean claim rate, denial rate, collection rate, reimbursement trends, cash collections, payer performance, and revenue forecasting; provide regular analysis and recommendations to executive leadership.

Skills and Competencies

• Advanced expertise in behavioral health revenue cycle management, including timely billing, accounts receivable optimization, denial management, appeals, and cash flow performance.
• Deep knowledge of Alaska Medicaid billing requirements and payer reimbursement structures, with the ability to interpret and operationalize regulatory and contractual standards.
• Strong command of coding standards, billing workflows, and EHR system configuration (CareLogic preferred) to ensure accurate, compliant, and efficient billing.
• Executive-level understanding of documentation integrity, medical necessity, and golden thread alignment as foundational to defensible reimbursement.
• Proven leadership and analytical capability to align billing, quality assurance, and compliance functions through data-driven decision-making and cross-functional collaboration.

Qualifications

• Two years of college education in accounting and two years' experience in the accounting field OR Four years' experience in Medicaid and third-party insurance billing
• Ability to make sound decisions based on information available
• Excellent organization skills, self-motivated, ability to work without direct supervision
• Ability to work flexible hours, including days, evenings and some weekend hours
• Ability to travel if required

Working Conditions

The work environment characteristics and physical demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Works in office area. Interacts with staff, consultants, and outside vendors. May be subjected to interruptions throughout the workday.
• While performing the duties of this job the employee is frequently required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is occasionally required to lift up to 25 pounds. The vision requirement includes close vision.

Acknowledgement

Every effort has been made to identify the essential functions of this position. However, this job description in no way states or implies that these are the only duties you may be required to perform. The omission of specific descriptions of duties does not exclude them from the position if the work is similar, related or can be considered essential to this position.