Senior Director, RCM Operations

GeneDx (Nasdaq: WGS) delivers personalized and actionable health insights to inform diagnosis, direct treatment, and improve drug discovery. The company is uniquely positioned to accelerate the use of genomic and large-scale clinical information to enable precision medicine as the standard of care. GeneDx is at the forefront of transforming healthcare through its industry-leading exome and genome testing and interpretation services, fueled by the world’s largest, rare disease data sets. For more information, please visit www.genedx.com. 

Summary  

The Senior Director, RCM Operations, is responsible for leading and optimizing all aspects of revenue cycle operations, including prior authorization, cash posting, payer correspondence, and denial management. This role ensures compliance, drives operational efficiency, and partners with executive leadership to achieve financial performance goals. The Senior Director will lead strategic initiatives to improve reimbursement outcomes, reduce aging accounts receivable, and implement automation and best practices across the organization.  

Job Responsibilities 

• Strategic Leadership  

• Develop and execute long-term strategies for revenue cycle optimization. 

• Collaborate with VP Billing and Reimbursement to align operational goals with organizational objectives and financial targets. 
• Identify potential risks to revenue based on payer policies and requirements. 
• Operational Oversight  

• Direct daily operations for entire revenue cycle from prior authorization, claim submission through claim follow-up, appeals, payment posting and correspondence. 

• Prioritize collection and appeals efforts to support revenue collections. 

• Identify risks based on payer denials and collaborate with internal stakeholders to remove roadblocks. 

• Prepare metrics and data analysis of successes and projects for the RCM team. 

• Ensure timely and accurate posting of payments and routing of payer communications. 

• Compliance & Risk Management  

• Maintain adherence to HIPAA, payer guidelines, and audit requirements. 

• Implement and monitor SOPs for compliance across all workflows. 
• Create workflows to ensure efficient collections and accounts receivable operations. 
• Team Leadership  

• Recruit, mentor, and develop high-performing teams. 

• Foster a culture of accountability, innovation, and continuous improvement. 
• Contribute to overall employee success by evaluating performance on a regular basis and provide effective feedback for growth and improvement. 
• Analytics & Reporting 

• Analyze payment and denial trends to identify improvement opportunities. 
• Provide actionable insights and reporting to senior leadership. 
• Technology & Process Improvement  

• Drive automation and system enhancements to improve efficiency. 
• Champion change management and adoption of new tools and processes. 

People Manager 

• Yes  

Education, Experience, and Skills 

• Bachelor’s degree in healthcare administration, business, finance, or related field (Master’s preferred).  

• Minimum 10 years of progressive experience in revenue cycle management, with at least 5 years in a senior leadership role.  

• Deep knowledge of healthcare billing, payer remittance, and regulatory compliance.  

• Proven track record of leading large teams and driving operational improvements. <