Director of Revenue Cycle - Patient Acounts

Director of Revenue Cycle - Patient Acounts | Summit Healthcare Mgmt | Franklin, Tennessee

About the Job:

PURPOSE STATEMENT:

The Director-Patient Accounts is responsible for leading and optimizing daily billing operations, payment posting, reconciliation, and patient/customer service functions across the revenue cycle. This role combines strategic leadership with active operational oversight, ensuring high-performance execution across all areas.
The Director is accountable for improving claim accuracy, accelerating cash application, enhancing the patient financial experience, reducing rework, and ensuring consistent, compliant, and efficient processes across billing, cash posting, and customer-facing support teams.

Roles and Responsibilities:

ESSENTIAL FUNCTIONS:

• Lead and maintain direct oversight of daily institutional and/or professional billing operations to ensure timely, accurate claim generation and submission.
• Actively monitor claim edits, claim holds, late charge activity, rebills, corrections, and bill release workflows to ensure efficient throughput.
• Ensure billing processes consistently meet payer requirements, coding and documentation dependencies, and internal policies.
• Review and respond to performance indicators including claim volume, clean-claim rates, billing lag, rejection trends, and unresolved billing exceptions.
• Partner closely with Patient Access, HIM, Coding, Utilization Review, and operational departments to resolve barriers impacting claim accuracy and timeliness.
• Intervene in escalated or complex billing issues to ensure resolution and prevent recurrence.
• Direct and oversee all payment posting activities including electronic remittances, manual posting, contractual adjustments, denials at posting, refunds, and unapplied cash workflows.
• Maintain active oversight of daily reconciliation processes, ensuring alignment of cash, EFT, lockbox, credit card, and manual payments to the general ledger and bank reporting.
• Ensure payments and adjustments are posted accurately and timely in accordance with payer contracts and internal controls.
• Monitor credit balances, posting variances, and unapplied cash aging; implement corrective actions and process improvements.
• Partner with Finance and Treasury on reconciliation processes, month-end close, and audit support.
• Stay engaged in high-risk or complex reconciliation issues to ensure timely resolution.
• Lead patient/customer service operations with direct visibility into daily performance and service delivery.
• Ensure staff provide accurate, timely, and professional communication regarding balances, billing inquiries, payment options, and account status.
• Monitor call quality, service levels, abandonment rates, first-contact resolution, and escalation trends; take action to address gaps.
• Oversee complaint resolution and service recovery efforts to ensure a positive patient financial experience.
• Develop and refine scripts, workflows, and training to support consistency, compliance, and service excellence.
• Lead a multi-level team including managers, supervisors, leads, and frontline staff across billing, cash posting, and customer service.
• Provide hands-on leadership through coaching, quality reviews, productivity monitoring, and performance management.
• Oversee staffing plans to support operational demands.
• Foster a culture of accountability, responsiveness, accuracy, and continuous improvement.
• Ensure teams are trained and aligned with evolving payer requirements, workflows, and organizational expectations.
• Analyze billing, cash posting, reconciliation, and customer service data to identify performance gaps, risks, and improvement opportunities.
• Maintain regular review of dashboards and KPIs, taking timely corrective action to drive performance.
• Prepare and present operational summaries and insights to senior leadership.
• Support and lead workflow redesign, automation initiatives, system enhancements, and process standardization efforts.
• Ensure strong internal controls and maintain audit readiness across billing, cash handling, adjustments, and refund processes.

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• Bachelor’s degree in Healthcare Administration, Business, Finance, Accounting, or related field preferred; equivalent relevant experience may be considered in lieu of degree.
• Five or more years of progressive healthcare revenue cycle experience required.
• Experience in hospital, behavioral health, acute care, physician revenue cycle, or multi-site healthcare operations preferred.
• Strong knowledge of billing workflows, claim edits, clearinghouse processes, payment posting, electronic remittance