Description:

JOB SUMMARY

The Director of Revenue Cycle is responsible for overseeing all aspects of the revenue cycle process within the organization, including patient access, billing, collections, coding, reimbursement, and compliance. This position ensures that revenue cycle operations align with federal and state regulations, payer requirements, and organizational financial goals. The Director will lead teams across patient financial services, health information management, and billing functions to optimize efficiency, reduce denials, and maximize revenue capture.

DISTINGUISHING CHARACTERISTICS

This role requires a highly strategic leader with expertise in healthcare finance, regulatory compliance, payer relations, and revenue cycle technology. The Director must balance operational leadership with regulatory knowledge (e.g., CMS, HIPAA, Medi-Cal, Medicare, and commercial payers), while maintaining strong communication with clinical and administrative departments.

ESSENTIAL JOB DUTIES & RESPONSIBILITIES:

The following are exemplary essential job duties and responsibilities and are not intended to represent an all-inclusive listing of related essential functions of the position.

Leadership & Strategy

Develop and implement revenue cycle strategies to ensure timely and accurate billing, collections, and reimbursement.
Lead, mentor, and evaluate teams in patient access, billing, coding, and collections.
Collaborate with clinical and administrative leaders to improve workflows affecting reimbursement.

Financial Performance

Monitor key performance indicators (KPIs) such as days in accounts receivable (AR), denial rates, collection efficiency, and cash flow.
Develop revenue cycle dashboards and reports for executive leadership.
Identify areas for process improvement and implement corrective actions.

Compliance & Risk Management

Ensure adherence to state and federal regulations (California Department of Health Care Services, Medi-Cal, Medicare, HIPAA).
Maintain compliance with payer contracts, coding regulations, and billing requirements.
Lead internal audits and respond to payer audits or inquiries.

Revenue Integrity & Technology

Oversee charge capture, coding accuracy, and documentation improvement initiatives.
Implement and optimize revenue cycle technologies, including EHR and billing systems.
Partner with IT and compliance departments to strengthen revenue integrity.

Stakeholder Engagement

Serve as primary liaison between the organization and third-party payers.
Develop and maintain effective communication with patients regarding financial responsibilities.
Educate clinical and administrative staff on revenue cycle best practices.

OTHER WORK AS REQUIRED/REQUESTED

May be assigned special project or other assignments and work tasks that are generally within the scope and level of the position, and relative to the need for flexible Company operations.

MINIMUM & PREFERRED QUALIFICATIONS:

Education/Training

Minimum: Bachelor’s degree in Healthcare Administration, Finance, Business

Preferred: Master’s degree preferred

Experience

Minimum: 7–10 years of progressive experience in healthcare revenue cycle management, with at least 3 years in a senior leadership role. Strong knowledge of Medi-Cal, Medicare, commercial insurance, and California-specific payer regulations. Expertise in medical billing, coding, compliance, and reimbursement methodologies. Experience with EHR and revenue cycle management systems (e.g., Epic, Cerner, Allscripts).

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.

Skills, Knowledge & Abilities

Advanced knowledge of revenue cycle processes, payer regulations, and healthcare reimbursement.
Strong financial and analytical skills, with ability to interpret complex data.
Excellent leadership, communication, and conflict resolution skills.
Ability to work collaboratively with physicians, administrators, and external stakeholders.
Strong problem-solving skills with an emphasis on process improvement

Requirements:

Education/Training

Minimum: Bachelor’s degree in Healthcare Administration, Finance, Business

Preferred: Master’s degree preferred

Experience

Minimum: 7–10 years of progressive experience in healthcare revenue cycle management, with at least 3 years in a senior leadership role. Strong knowledge of Medi-Cal, Medicare, commercial insurance, and California-specific payer regulations. Expertise in medical billing, coding, compliance, and reimbursement methodologies. Experience with EHR and revenue cycle management systems (e.g., Epic, Cerner, Allscripts).

Arrowhead Orthopaedics

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Director of Revenue Cycle