Revenue Cycle Director

Position Summary

The Revenue Cycle Director oversees all billing, collections, and reimbursement operations to

ensure accurate, timely, and compliant revenue capture across VIP’s health care programs. This

leader manages the full revenue cycle team, ensures adherence to regulatory and payer

requirements, and drives continuous improvement through data-driven decision-making.

A key expectation of this role is the ability to leverage AI-powered tools, analytics platforms,

and automated dashboards to enhance billing accuracy, accelerate collections, and provide

leadership with real-time financial insights

Key Responsibilities

Revenue Cycle Leadership & Oversight

• Direct denial management and appeals processes, implementing root-cause

analysis to reduce future claim rejections.

• Serve as a key liaison with VIP’s billing consultant, external vendors, and insurance

payers to address operational issues and strengthen financial outcomes.

• Manage and supervise daily operations of the billing, collections, and revenue cycle

team.

• Monitor key performance indicators (KPIs) such as days in accounts receivable,

denial rates, net collection rates, and clean claim rates to ensure departmental

effectiveness and financial stability.

• Ensure compliance with federal, state, and payer regulations including billing

standards, documentation requirements, and reimbursement policies.

• Maintain up-to-date knowledge of CPT, ICD-9/ICD-10, commercial insurance, Medicaid

and Medicare rules, and health care billing standards.

Contract & Payer Management

• Oversee payer contract management, proactively establish new payer agreements

and collaborate with finance and executive leadership to maximize reimbursement

and resolve payer issues.

• Negotiate service rates and resolve payment or billing issues with insurance companies.
• Ensure concrete understanding of contractual obligations and implement strategies to

comply with contractual obligations.

• Ensure patients with non-participating insurance companies are informed and redirected

Billing Compliance & Quality Assurance

• Monitor regulatory changes (OASAS, Medicaid, etc.) and implement required updates in

billing systems.

• Develop and maintain written procedures for fee establishment, billing, and collections.
• Coordinate internal and external audits related to billing, coding, and revenue cycle

processes and implement corrective action plans when necessary. Lead initiatives

to improve revenue integrity, including charge capture accuracy, documentation

compliance, and coding quality.

Client Eligibility, Authorization & Documentation

• Monitor key performance indicators (KPIs) such as days in accounts receivable,

denial rates, net collection rates, and clean claim rates to ensure departmental

effectiveness and financial stability.

• Oversee daily insurance verification and benefit checks.
• Ensure timely authorization/pre-certification for new and ongoing treatment services.
• Track authorized visits and distribute treatment plan requirements to counseling staff.
• Notify staff of changes in Medicaid or insurance status.

Financial Operations & Reporting

• Collaborate with clinical, compliance, and finance teams to align operational

workflows with reimbursement requirements and regulatory standards.

• Perform and oversee financial transactions including verifying, classifying, computing,

posting, and reconciling accounts receivable.

• Match billing accounts with the A/R ledger to ensure accurate payment posting.
• Prepare and present regular reports on accounts status, collections, denials, and revenue

trends.

• Manage revenue cycle technology platforms including electronic health record

(EHR), practice management systems, and billing software to enhance efficiency

and reporting capabilities.

AI-Enabled Reporting, Analytics & Dashboard Development

• Use AI-powered tools to automate billing quality checks, identify anomalies, and flag

potential denials.

• Develop smart dashboards that visualize KPIs such as days in A/R, denial rates,

authorization timeliness, and collection efficiency.

• Build predictive models to forecast revenue, identify bottlenecks, and optimize workflow

performance.

• Train staff on using AI-assisted tools for eligibility verification, claims scrubbing, and

documentation accuracy.

• Integrate AI insights into monthly leadership reports and strategic planning.

Collaboration & Staff Development

• Develop and mentor revenue cycle staff, establishing performance goals, training

programs, and professional development initiatives. Collaborate with clinical,

administrative, and IT teams to ensure accurate documentation and smooth billing

operations.

• Promote a culture of accountability, continuous improvement, and data-driven

decision-making.

Minimum Qualifications

• Bachelor’s degree required. Masters preferred
• Minimum 5 years of supervisory experience in a health care billing environment.
• Prior billing experience in behavioral health required.
• Demonstrated billing compliance experience.
• Proficiency with CPT, ICD-9/ICD-10, and coding systems.
• Experience with electronic health records (EHR/EMR) systems.
• Strong communication, administrative, organizational, and interpersonal skills.
• Computer literacy and familiarity with billing systems.
• Experience with Medicaid, Medicare, and private insurance billing.
• Skills in medical billing, collections, EHR systems, insurance authorizations, and payer

relations.

Preferred Qualifications

• Experience using AI-driven analytics, reporting tools, or automated dashboards.
• Familiarity with Power BI, Tableau, or similar visualization platforms.
• Knowledge of AI-assisted claims scrubbing or predictive denial management tools.