Director of Revenue Cycle & Billing
Plymouth, MA
Full Time
Senior Manager/Supervisor
Ophthalmic Consultants of Boston is current seeking a dynamic Director for our Revenue and Billing group.
We are seeking a strategic and hands-on Director of Revenue Cycle and Billing to oversee and optimize the entire revenue cycle across multiple departments, including Front Desk Operations, Central Scheduling/Call Center, Credentialing, Billing, and Medical Claims Management. This leadership role requires a dynamic professional with deep expertise in healthcare operations, claims submission, payer relations, and staff development.
The successful candidate will lead high-volume operations, ensure compliance with industry standards, drive revenue growth, and foster a culture of excellence and accountability.
Key Responsibilities:
Qualifications:
We are seeking a strategic and hands-on Director of Revenue Cycle and Billing to oversee and optimize the entire revenue cycle across multiple departments, including Front Desk Operations, Central Scheduling/Call Center, Credentialing, Billing, and Medical Claims Management. This leadership role requires a dynamic professional with deep expertise in healthcare operations, claims submission, payer relations, and staff development.
The successful candidate will lead high-volume operations, ensure compliance with industry standards, drive revenue growth, and foster a culture of excellence and accountability.
- Lead and oversee the day-to-day operations of the Revenue Cycle, including Front Desk, Central Scheduling/Call Center, Credentialing, Billing, and Prior Authorization functions.
- Manage high volumes of inbound and outbound calls, ensuring quality assurance and call center performance metrics are met.
- Direct the submission of medical claims, denial management, and Accounts Receivable follow-up processes with a strong focus on accuracy and timely reimbursements. This includes efforts to improve self-pay collections.
- Oversee prior authorizations and insurance appeal processes, coordinating closely with payers to ensure approval and minimize delays.
- Ensure accurate use of ICD-10, CPT, and HCPCS coding in collaboration with billing and clinical staff.
- Hire, train, and supervise revenue cycle billing and front-end teams, promoting continuous development and strong interdepartmental collaboration. Lead regular training sessions and meetings with managers and staff.
- Establish operational benchmarks, KPIs, and performance dashboards to measure efficiency and revenue impact.
- Work collaboratively with Finance, Compliance, and Clinical Operations to ensure alignment of financial goals and patient satisfaction.
- Lead initiatives in budgeting, cost reduction, and revenue optimization, using data analytics and financial modeling.
- Develop and present detailed revenue reports, forecasts, and presentations to executive leadership, offering insight into trends, opportunities, and performance.
- Ensure adherence to all regulatory requirements, including HIPAA, CMS, and payer-specific guidelines.
- Support the physicians with billing and reimbursement questions and help develop practice policies related to the revenue cycle.
- Serve as the key expert in the billing system (Epic Resolute) for staff, physicians, clinical, and administrative team members.
- Bachelor’s degree in healthcare administration, Business, Finance, or a related field required
- 7–10 years of progressive experience in revenue cycle management, including at least 3 years in a director or senior management role.
- Proven experience managing high-volume patient access and billing operations, including scheduling, call centers, and prior authorizations.
- Advanced understanding of medical billing procedures, insurance processes, appeals, and payer communications.
- Strong knowledge of ICD-10, CPT, and medical coding principles.
- Skilled in staff hiring, training, and leadership with the ability to build and maintain high-performing teams.
- Demonstrated success in revenue analytics, budget oversight, and implementation of cost-saving measures.
- Proficiency with EHR and PM systems (e.g., Epic, Athenahealth, eClinicalWorks, NextGen).
- Excellent communication and presentation skills with the ability to influence across departments and leadership levels.
Benefits Offered:
- Health & Dental Insurance- eligible 1st day of employment
- Paid time off and paid holidays
- Health & Dependent Reimbursement Accounts
- 401(k) Plan with company contribution
- Company paid Life and LTD Insurance
- Employee discounts
To find out more about OCB, please visit our website at www.eyeboston.com. OCB is an Equal Opportunity Employer.
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