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Healthcare Revenue Optimization Director
3 days ago
We are seeking an experienced leader to oversee our revenue cycle operations, ensuring smooth processes and optimal results.
About the Role:This onsite, night-shift position (7 PM – 4 AM PKT, aligned with U.S. Central Time) requires a seasoned Revenue Cycle Manager to lead and optimize our revenue cycle operations.
The ideal candidate should have 6–8 years of experience in revenue cycle management, with at least 3 years in a leadership role managing client relationships and overseeing an onsite team across multiple functions, including credentialing, insurance verification, accounts receivable, medical billing, payment posting, and prior authorizations.
- Provide strategic leadership to the revenue cycle team, ensuring smooth operations and process optimization.
- Oversee the entire revenue cycle process, including charge capture, coding, billing, claims submission, payment posting, and denial management.
- Ensure timely and accurate claims processing to minimize denials and maximize reimbursement.
- Lead and manage an onsite team handling credentialing, verification, accounts receivable, medical billing, payment posting, and prior authorizations.
- Develop and maintain strong relationships with clients, ensuring seamless communication and service delivery.
- Monitor accounts receivable (A/R) and implement strategies to reduce outstanding balances.
- Ensure compliance with HIPAA, Medicare, Medicaid, and other payer regulations.
- Analyze revenue cycle performance metrics, identify areas for improvement, and implement corrective actions.
- Work closely with healthcare providers, insurance companies, and internal teams to resolve billing issues and reimbursement delays.
- Keep up-to-date with changes in medical billing codes (CPT, ICD-10), insurance policies, and industry regulations.
Key Qualifications:
- Bachelor's or Master's degree in Finance, Accounting, Business Administration, ACCA, CA, or a related field.
- 6–8 years of experience in revenue cycle management, medical billing, or healthcare finance.
- At least 3 years of leadership experience managing client relationships and an onsite team across multiple revenue cycle functions.
- Strong understanding of U.S. healthcare billing systems, payer rules, and reimbursement methodologies.
- Proficiency in EHR/EMR systems, medical billing software, and clearinghouses.
- Knowledge of insurance verification, credentialing, prior authorizations, and denial management.
- Strong leadership skills with the ability to motivate and manage a team.
- Excellent analytical, problem-solving, and communication skills.
- Certification in medical billing and coding (CPC, CPB, or similar) is a plus.
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