Director of Revenue Cycle Management (Chesapeake Specialty Care)

About the role

The Director of Revenue Cycle Management is responsible for overseeing all aspects of the revenue cycle, from patient registration and insurance verification through final payment collection. This leadership role ensures optimal reimbursement, regulatory compliance, and financial performance across all service lines and the ASC. The Director will lead and develop the billing team while implementing best practices to maximize revenue and minimize denials.     Essential Functions Oversee end-to-end revenue cycle functions including patient access, charge capture, coding, billing, collections, and payment posting   Manage revenue cycle operations for both the medical practice and ambulatory surgery center   Monitor and analyze key performance indicators (KPIs) including days in A/R, denial rates, clean claim rates, and collection percentages   Develop and implement policies and procedures to optimize revenue capture and reduce claim denials   Ensure accurate and timely claim submission across all payer types (commercial, Medicare, Medicaid, workers' comp)   Multi-Specialty Billing Oversight     Maintain expertise in specialty-specific billing requirements for ENT, Allergy, Audiology, Facial Plastics, and Full Body Plastics procedures   Oversee ASC facility billing and ensure proper coordination with professional fee billing   Ensure compliance with coding guidelines (CPT, ICD-10, HCPCS) specific to each specialty   Manage prior authorization processes, particularly for surgical procedures and implantable devices (hearing aids, cochlear implants, cosmetic vs. reconstructive determinations). Team Leadership & Development     Lead, mentor, and develop the billing team    Establish performance standards, conduct regular evaluations, and provide ongoing training   Foster a culture of accountability, continuous improvement, and excellent customer service   Coordinate with Clinical Managers, Surgical Coordinators, and Practice Administrator   Compliance & Regulatory     Ensure compliance with federal and state healthcare regulations, HIPAA, and payer requirements   Stay current on regulatory changes affecting reimbursement (CMS updates, payer policy changes)   Conduct regular audits to ensure coding accuracy and billing compliance   Manage payer contract analysis and assist with contract negotiations     Financial Reporting & Analysis     Prepare and present regular reports on revenue cycle performance to leadership and physician owners   Identify trends, variances, and opportunities for revenue enhancement   Develop and manage departmental budget   Collaborate with Practice Administrator on financial planning and forecasting     Education and/or experience   Required:     Bachelor's degree in healthcare administration, Business, Finance, or related field   Minimum 7-10 years of progressive experience in healthcare revenue cycle management   At least 3-5 years in a leadership/management role   Experience with multi-specialty physician practice billing   Experience with ASC/facility billing strongly preferred   Proficiency with practice management systems and EHR platforms   Strong knowledge of CPT, ICD-10, and HCPCS coding systems   Thorough understanding of payer contracts, reimbursement methodologies, and healthcare regulations   Preferred:     Master's degree in healthcare administration, MBA, or related field   Professional certification: CPMA, CPC, CRCE-I, or similar   Skills & Competencies     Strong analytical and problem-solving abilities   Excellent leadership and team development skills   Superior communication skills (written and verbal)   Ability to work collaboratively with physicians, clinical staff, and administrative teams   Proficiency in Microsoft Excel, reporting tools, and data analysis   Detail-oriented with ability to manage multiple priorities   Strategic thinking with operational execution capability   Experience with ENT, Audiology, and/or Plastic Surgery billing   Experience with surgical scheduling and authorization workflows     Total Rewards   The referenced base salary range represents the low and high end of Specialty Care Networks’ salary range for this position. Some candidates will not be eligible for the upper end of the salary range. Exact salary will ultimately depend on multiple factors, which may include the successful candidate’s geographical location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/ training and other qualifications. Specialty Care Network offers a total rewards package that supports our employee’s life, career and retirement.