Job Description
Position Overview
The Director of Revenue Cycle is responsible for overseeing and optimizing all revenue cycle operations with a focus on improving billing efficiency, claim accuracy, denial prevention, and overall financial performance. This leadership role will drive process improvements, support automation initiatives, and ensure compliance with healthcare billing regulations while collaborating with cross-functional teams to improve workflows and operational outcomes.
Key Responsibilities
The Director of Revenue Cycle is responsible for overseeing and optimizing all revenue cycle operations with a focus on improving billing efficiency, claim accuracy, denial prevention, and overall financial performance. This leadership role will drive process improvements, support automation initiatives, and ensure compliance with healthcare billing regulations while collaborating with cross-functional teams to improve workflows and operational outcomes.
Key Responsibilities
- Lead and manage daily revenue cycle operations including billing, coding, claims processing, A/R follow-up, payment posting, and denial management.
- Drive initiatives focused on improving clean claim rates, reducing denials, and increasing operational efficiency.
- Analyze workflows and identify opportunities for automation and process improvement across the revenue cycle.
- Monitor key performance metrics including denial rates, productivity, days in A/R, and claim acceptance rates.
- Develop and implement policies, procedures, and standardized billing workflows to ensure compliance and accuracy.
- Collaborate with finance, operations, and internal departments to support system enhancements and process alignment.
- Lead, mentor, and develop billing and revenue cycle teams while promoting accountability and performance improvement.
- Ensure compliance with Medicare, commercial payer guidelines, and healthcare billing regulations.
- Assist with reporting, analytics, and strategic planning related to revenue cycle performance.
- 10+ years of healthcare revenue cycle experience required.
- 5+ years of leadership or management experience within billing or revenue cycle operations.
- Strong understanding of Medicare, commercial insurance, HMO, and PPO billing regulations.
- Experience with EMR/EHR systems required.
- Knowledge of denial management, claims adjudication, and billing compliance processes.
- Strong analytical, leadership, communication, and problem-solving skills.
- Intermediate to advanced Microsoft Excel and Microsoft Office experience preferred.
- Bachelor’s degree preferred;equivalent combination of education and experience may be considered.
- Experience with Medicare Advantage claims adjudication.
- Background leading automation or process improvement initiatives within revenue cycle operations.
Numbers & Facts
| Location | San Antonio, TX |
| Industry | Staffing/Employment Agencies |
| Company Size | 100 to 499 employees |
| Website | https://www.prg-usa.com/ |
About Company
Established in 2001, Peyton Resource Group is a solution-based staffing company that matches businesses with top talent for short-term, long-term or permanent needs.
People are a business’s most valuable asset. Peyton Resource Group is dedicated to helping companies find the best talent, matching professionals with jobs where they will thrive.
With locations in Dallas/Fort Worth, San Antonio and Austin, we are available to serve your staffing needs throughout Texas and across the country.
Skills
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