Revenue Cycle Director jobs in Massachusetts

About the Role

InStride Health seeking a highly skilled and motivated Director of Revenue Cycle to join our team. The Director of Revenue Cycle will play a pivotal role in overseeing both front end and back end revenue cycle operations, ensuring efficient billing processes and maximizing revenue collection. This individual will report directly to our VP of Finance and help lead our billing team, providing guidance and support to ensure compliance with industry regulations and company policies. In addition, this individual will collaborate cross-functionally to ensure accurate and timely revenue collection while maintaining a strong focus on customer service and enhancing overall financial performance.

Responsibilities

• Revenue Optimization: Oversee all aspects of revenue cycle management, including billing, coding, reimbursement, and collections, to maximize revenue generation and minimize revenue leakage.
• Develop and Implement Revenue Cycle Strategies: Create and execute strategies to optimize the revenue cycle process, including patient registration, insurance verification and eligibility, patient responsibility, authorizations, claims processing, payment posting, and collections.
• Infrastructure Development: Establish scalable infrastructure and processes to support the company's growth while ensuring compliance with healthcare regulations such as HIPAA and billing guidelines.
• Revenue Analysis and Reporting: Establish key performance indicators (KPIs) and metrics to monitor revenue cycle performance, identify areas for improvement, and drive operational excellence. Analyze revenue trends and KPIs, identify areas for improvement, and prepare comprehensive reports for management to make informed decisions.
• Technology Integration: Evaluate and implement revenue cycle technologies and systems to streamline processes, enhance efficiency, and improve accuracy.
• Vendor Management: Evaluate, implement and manage relationships with third-party vendors, such as billing software providers and collection agencies, to optimize services and costs.
• Payor Management: In partnership with our Payor Solutions team, collaborate with InStride’s new and existing payor relationships to ensure smooth implementation of new payor contracts and ongoing revenue cycle activities with current partners  
• Compliance and Regulatory Oversight: Stay updated on changes in healthcare regulations and ensure compliance in all revenue cycle activities to minimize risks of audits or penalties.
• Collaboration with Other Departments: Partner with departments including payor solutions, technology/data/IT, and clinical operations to streamline processes and resolve issues impacting revenue cycle performance.
• Team Leadership: Build and lead a team of billing and revenue cycle professionals, providing guidance, training, and performance management to ensure efficiency and effectiveness in operations.
• Continuous Improvement: Identify opportunities for process improvement and automation to enhance efficiency, reduce errors, and accelerate revenue generation.

What You Need to Succeed in the Role

• 4 years of experience in healthcare revenue cycle management, preferably in a leadership role. Experience in a rapidly growing clinical services company and Value-Based Care arrangements are highly desirable 
• Strategic Thinking: Ability to develop and execute strategic plans to optimize the revenue cycle process and support the company's growth objectives.
• Cross-Functional Collaboration: Demonstrated ability to collaborate effectively cross-functionally with payor (growth), tech/IT/data, and clinical operations teams.
• Leadership Skills: Demonstrated leadership capabilities, including team building, coaching, and performance management, to lead and motivate a team of revenue cycle professionals.
• Analytical Skills: Proficiency in data analysis and reporting tools to analyze revenue trends, identify areas for improvement, and make data-driven decisions.
• Communication Skills: Excellent communication skills to effectively collaborate with cross-functional teams, communicate financial performance metrics, and articulate revenue cycle strategies to senior management.
• Problem-Solving Ability: Strong problem-solving skills to address complex issues related to billing, claims processing, denials management, and reimbursement discrepancies.
• Adaptability: Ability to adapt to changing regulatory requirements, industry trends, and organizational needs in a fast-paced and dynamic environment.
• Knowledge of Healthcare Regulations: Strong understanding of healthcare regulations, compliance requirements, and billing guidelines
• Ability to work independently and professionally in a fast-paced environment; ability to be flexible
• Ability to handle sensitive and confidential information in a manner that inspires confidence and trust

Why Join Our Team

• Opportunity to join a mission-driven company that is changing the landscape of pediatric mental health treatment
• Ability to help hundreds of children and families access desperately-needed evidence-based care
• Opportunity to work with talented and experienced team members who have devoted their lives to solving this problem
• Competitive compensation and generous benefits package for doing what you love
• 401(k) with employer matching
• Paid parental leave policy
• 4-week paid sabbatical after 5 years of employment 
• Fully remote work environment, enabling you to work from the comfort of your home with periodic, in-person team retreats