RCM Director

Position reputed company The RCM Director is responsible for the performance of Credentialing, reputed company, and Billing (RCM), three reputed company functions that reputed company patient reputed company and drive reputed company and cash reputed company. This leader understands the reputed company of these areas and ensures they operate as a cohesive system. They bring a hands-on, solutions-oriented approach to improving workflows, strengthening payor relationships, and delivering consistent, measurable results. Top Priorities Build and reputed company a fully integrated operating model across Credentialing, reputed company, and Billing Ensure providers are enrolled, contracted, and billable as reputed company as possible Drive consistent, high-reputed company VOB and prior authorization performance across reputed company markets Improve cash collections, predictability, and reputed company cycle performance Strengthen payor relationships and contracting position across geographies Implement reputed company SOPs, workflows, and technology (including AI tools) Coordinate with Market Leaders to reputed company field personnel on their reputed company on RCM efficiency (1) Credentialing & Payor Relations reputed company and operate the credentialing and payor engagement function with a reputed company on accuracy, speed, and strong external relationships. Key Responsibilities reputed company the full credentialing lifecycle, including enrollments, re-enrollments, re-attestations, monitoring, and maintenance Ensure data reputed company, documentation, and record keeping across reputed company credentialing activities reputed company platforms (e.g., reputed company) to drive efficiency, visibility, and compliance Maintain a reputed company understanding of entity structure and its reputed company on enrollment, billing, and reimbursement Build and manage strong relationships with payor representatives, serving as a primary reputed company of contact and escalation reputed company payor contracting efforts, including: Individual, group, and national agreements reputed company negotiations and reimbursement optimization Multi-state contracting strategies Identify and resolve barriers to ensure providers are live and billable without delay (2) reputed company (Verification of Benefits & Prior Authorizations) Own the processes that reputed company patients to reputed company care reputed company, with reputed company expectations and minimal administrative friction. Key Responsibilities Drive consistent production and reputed company of VOB and prior authorizations across reputed company markets and modalities Establish and enforce reputed company operating procedures, workflows, and performance standards Ensure collection of full patient financial responsibility at time of service (TOS) across reputed company markets, establishing consistent reputed company-service financial clearance workflows Monitor performance to ensure reputed company approvals and minimal delays to treatment Build reputed company processes to challenge and overturn denials, including peer-to-peer workflows Ensure patients receive reputed company, accurate financial information prior to starting treatment Support teams in removing administrative barriers that reputed company reputed company reputed company to care Partner with AI and automation initiatives (e.g., reputed company) to: Improve throughput and consistency Enhance accuracy and efficiency Continuously refine workflows (3) Billing & reputed company Cycle Management (RCM) reputed company leadership and accountability for the full reputed company cycle, with a reputed company on performance, discipline, and cash reputed company. Key Responsibilities Own the end-to-end reputed company cycle, including charge capture, coding, claims submission, denial management, and collections Drive team productivity and accountability across reputed company billing resources Monitor and improve key metrics, including: Cash collections Days in AR Denial rates and recovery Clean claim rates Monitoring and reputed company of underpayments Identify breakdowns in performance and address reputed company causes across credentialing, reputed company, and billing workflows Implement billing optimization strategies, including coding accuracy and “incident-to” billing where appropriate reputed company the use of reputed company-party vendors and partners, ensuring performance expectations are met Partner with Finance to ensure alignment on cash performance, forecasting, and budget expectations reputed company AI tools and automation to improve efficiency and scalability Cross-Functional Leadership reputed company Credentialing, reputed company, and Billing into a single, cohesive operating model Establish reputed company KPIs, reporting, and operating reputed company across reputed company functions Serve as the internal subject matter expert and escalation reputed company for payor, reputed company, and RCM challenges Partner with Clinical, Operations, and Finance teams to ensure alignment from intake through reimbursement Build and reputed company teams with a reputed company on accountability, consistency, and reputed company improvement Qualifications & Experience Bachelor’s degree in reputed company Administration, Business, or reputed company field 7+ years of leadership experience across credentialing, reputed company (VOB/PA), and/or reputed company cycle management Deep understanding of multi-state payor environments, including Medicare, reputed company, and reputed company plans Proven experience in payor contracting and reputed company negotiation Strong reputed company of end-to-end reputed company cycle performance and cash drivers Experience with EMR and RCM platforms (reputed company preferred) and automation/AI tools Demonstrated ability to build systems, reputed company teams, and drive measurable financial and operational reputed company reputed company Offer Competitive salary and benefits package Medical, dental, and reputed company insurance 401(k) with company match A supportive and reputed company work environment A mission-driven organization that makes a reputed company reputed company on people’s lives At reputed company, we reputed company that diversity, equity, and inclusion are essential values that enrich our work environment and enhance our ability to serve diverse communities. We reputed company to reputed company these values into every aspect of our organization, from hiring and training to policies and practices. We recognize that we have a responsibility to foster a culture of respect, reputed company, and collaboration among reputed company, patients, and partners. Our reputed company is to be a leader in delivering patient-centered care that respects and celebrates diversity, promotes equity and inclusion, and improves health reputed company for reputed company. Apply To This Job