DIRECTOR OF REVENUE CYCLE

JOB SUMMARY

The Director of Revenue Cycle is a new role and will be responsible for developing and managing all aspects of revenue cycle operations, particularly the integration of Medicaid billing and managed care organization (MCO) processes. This is a high-impact position ideal for someone who is detail-oriented, strategic, and committed to improving the financial sustainability of a community-focused organization.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Revenue Cycle Strategy & Leadership

• Develop and implement a comprehensive revenue cycle management strategy.
• Establish protocols to ensure accurate and timely billing and collections.
• Monitor revenue performance and report financial trends to leadership.

• Review MCO contracts for included services and billing guidelines.
• Coordinate with MCOs to stay current on policy changes and reimbursement procedures.

• Develop a Medicaid billing process tailored to the organization’s services.
• Create and manage a Medicaid billing tracker.
• Ensure documentation aligns with Medicaid billing requirements.

• Supervise Billing Specialist
• Submit and manage claims through MCO billing portals.
• Review resident assessments to ensure proper documentation.
• Analyze billing denials and resubmit corrected claims.

• Assist with staff credentialing in NC Tracks.
• Maintain current provider enrollment and avoid service interruptions.

• Streamline documentation and billing workflows.
• Ensure compliance with all Medicaid and MCO regulations.
• Provide training to staff on billing protocols.

• Ensure compliance with agency policies, procedures, and standards, upholding the organization’s mission and values

POSITION QUALIFICATIONS:

• Bachelor’s degree in healthcare administration, finance, or related field (Master’s preferred).
• Minimum of 5 years in healthcare revenue cycle management, including Medicaid billing.
• Knowledge of NC Medicaid and MCO billing systems.
• Experience in behavioral health or substance use disorder treatment preferred.
• Proficiency in electronic billing systems and payer portals.
• Strong analytical and organizational skills.
• Ability to communicate clearly and train interdisciplinary teams.

      PHYSICAL REQUIREMENTS:

• Keyboarding
• Walking/Sitting
• Lifting