Director of Revenue

1 week ago

Boston, MA, United States Soni Resources Full time

The Senior Medical Revenue Specialist is responsible for leading all aspects of the revenue cycle, including patient billing, insurance claims, collections, grants receivables, and payer contracting for a healthcare-focused nonprofit organization. This role ensures the integrity of revenue processes, supports sustainable financial operations, and aligns revenue strategies with the organization's mission to improve community health outcomes.

Key Responsibilities:

Revenue Cycle Management

  • Oversee all functions of the revenue cycle including patient registration, charge capture, coding, billing, collections, and denial management.
  • Monitor and improve KPIs such as Days in A/R, cash collections, and denial rates.
  • Collaborate with clinical and administrative teams to ensure accurate documentation and coding.
Financial Strategy & Analysis
  • Develop revenue forecasts and support budgeting processes.
  • Analyze trends and variances in revenue streams (e.g., Medicaid/Medicare, commercial insurance, private pay, grants).
  • Recommend and implement strategies to optimize reimbursements and improve efficiency.
Payer Relations & Contracting
  • Manage relationships with third-party payers and negotiate reimbursement rates and terms.
  • Ensure compliance with payer guidelines, government regulations, and grant requirements.
Compliance & Risk Management
  • Maintain up-to-date knowledge of regulatory requirements (HIPAA, CMS, etc.).
  • Ensure billing practices align with legal and ethical standards.
  • Lead internal audits and address findings related to billing and revenue processes.
Leadership & Team Development
  • Supervise and develop revenue cycle staff, providing coaching, performance management, and training.
  • Foster a culture of accountability, transparency, and continuous improvement.
Qualifications:

Education:
  • Bachelor's degree in Finance, Accounting, Health Administration, or related field required.
  • Master's degree (MBA, MHA, MPH) preferred.
  • Certified Revenue Cycle Professional (CRCP) or similar certification a plus.
Experience:
  • Minimum 7-10 years of progressive experience in healthcare revenue cycle management.
  • At least 3 years in a leadership role within a nonprofit or healthcare setting.
  • Strong knowledge of Medicaid/Medicare billing, FQHC or behavioral health billing is highly desirable.
Skills:
  • Proficiency with revenue cycle systems and electronic health records
  • Strong analytical, strategic thinking, and problem-solving skills.
  • Excellent communication and interpersonal abilities.
  • Commitment to the mission and values of nonprofit healthcare.


Compensation: $100,000 to $115,000 annually
Salary is based on a range of factors that include relevant experience, knowledge, skills, other job-related qualifications.

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