Head of Revenue Cycle Management

Job Description:

The Head of Revenue Cycle Management (RCM) is responsible for leading and optimizing the end-to-end revenue cycle process to maximize organizational revenue, improve cash flow, and ensure compliance with healthcare regulations and payer requirements. This role oversees all aspects of patient billing, coding, claims management, reimbursement, accounts receivable, denial management, collections, and revenue integrity initiatives.

The Head of RCM develops and implements strategies to enhance operational efficiency, reduce claim denials, accelerate reimbursement cycles, and improve overall financial performance. They collaborate closely with executive leadership, clinical operations, finance, compliance, and information technology teams to drive process improvements, ensure regulatory adherence, and deliver a seamless patient financial experience.

Duties and Responsibilities:

• Leads and oversees the end-to-end Revenue Cycle Management (RCM) function, including patient registration, medical coding, billing, claims processing, reimbursement, accounts receivable, denial management, and collections.
• Develops and implements strategies to maximize revenue capture, improve cash flow, and enhance overall financial performance.
• Drives operational excellence by identifying process improvement opportunities, reducing claim denials, minimizing reimbursement delays, and increasing collection rates.
• Monitors key performance indicators (KPIs) and revenue cycle metrics to ensure organizational goals and financial targets are achieved.
• Ensures compliance with healthcare regulations, payer requirements, coding standards, and industry best practices.
• Collaborates with executive leadership, finance, clinical operations, compliance, and technology teams to align revenue cycle initiatives with organizational objectives.
• Oversees payer relationships, contract performance, reimbursement methodologies, and dispute resolution processes.
• Leads revenue integrity programs to ensure accurate charge capture, coding accuracy, and optimal reimbursement.
• Manages and develops high-performing RCM teams through effective leadership, coaching, training, and performance management.
• Leverages technology, analytics, and automation tools to improve efficiency, reporting accuracy, and revenue cycle outcomes.
• Conducts financial and operational analyses to identify trends, mitigate risks, and support strategic decision-making.
• Enhances the patient financial experience by promoting transparent billing practices and efficient resolution of patient account inquiries.
• Supports organizational growth by establishing scalable revenue cycle processes and implementing industry-leading practices.
• Provides regular reporting and recommendations to senior leadership regarding revenue performance, operational effectiveness, and strategic improvement initiatives.

Qualifications

• Accomplished healthcare revenue cycle leader with extensive experience managing end-to-end Revenue Cycle Management (RCM) operations, including patient access, medical coding, billing, claims processing, accounts receivable, denial management, collections, and reimbursement.
• Proven track record of maximizing revenue capture, improving cash flow, reducing claim denials, and optimizing financial performance through strategic process improvements and operational excellence.
• Skilled in developing and implementing revenue cycle strategies that enhance efficiency, ensure regulatory compliance, and support organizational growth objectives.
• Experienced in leading high-performing teams, fostering a culture of accountability, continuous improvement, and exceptional service delivery.
• Strong expertise in healthcare reimbursement methodologies, payer relations, revenue integrity, coding compliance, and healthcare financial management.
• Adept at analyzing key performance indicators (KPIs), identifying revenue leakage opportunities, and leveraging data-driven insights to improve revenue cycle outcomes.
• Effective collaborator with executive leadership, finance, clinical operations, compliance, and technology teams to drive cross-functional initiatives and achieve business goals.
• Proficient in utilizing revenue cycle technologies, analytics platforms, and automation tools to streamline workflows and enhance operational performance.
• Recognized for delivering sustainable revenue growth, improving collection rates, accelerating reimbursement cycles, and strengthening overall financial health within healthcare organizations.
• Strategic and results-oriented leader committed to driving operational excellence, financial stewardship, and an exceptional patient financial experience.