In this senior leadership role, you will oversee the entire revenue cycle for a growing network of specialty mental healthcare clinics, ensuring financial performance supports timely access to essential patient care. Reporting to the CFO, you will lead revenue cycle operations from eligibility verification and prior authorization through coding, claims management, denials, accounts receivable, and collections. You will identify the root causes of revenue leakage and operational delays, partnering with clinical, operational, finance, and product teams to implement lasting solutions. You will also evaluate the current balance between in-house coding and outsourced billing, using data to determine the most effective operating model and lead any necessary transition. With a strong focus on automation, AI-enabled workflows, and measurable performance improvements, you will help build a scalable, efficient, and accountable revenue cycle function. This is an opportunity to combine strategic financial leadership with hands-on operational problem-solving in a fast-moving, patient-centered healthcare environment.
Own the end-to-end revenue cycle: Lead all revenue cycle functions across the clinic network, including eligibility verification, prior authorizations, charge capture, medical coding, claims submission, denial management, accounts receivable, and patient collections.
Identify and eliminate root causes of denials: Analyze denial patterns, delayed authorizations, and payment issues to uncover underlying problems in intake, scheduling, clinical documentation, credentialing, and other upstream processes. Collaborate with relevant teams to correct workflows rather than relying solely on rework and appeals.
Lead coding operations and billing partnerships: Manage the in-house coding team and oversee the outsourced billing partner, establishing clear service-level agreements (SLAs), performance expectations, reporting standards, and accountability for results.
Evaluate and optimize the operating model: Within the first 12 months, assess the effectiveness of the existing revenue cycle structure and determine whether an in-house, outsourced, or hybrid approach best supports business objectives. Develop the business case and lead implementation of any approved transition.
Drive financial performance and reporting: Partner with finance leadership on revenue forecasting, cash flow management, month-end close, and payer contract performance. Own key metrics, including clean claim rate, denial rate, days in accounts receivable, and net collection rate.
Improve cross-functional workflows: Work closely with clinical, operational, and product teams to resolve process gaps that affect reimbursement and patient access. Translate revenue cycle findings into practical changes to intake procedures, documentation standards, scheduling workflows, and other operational processes.
Advance automation and AI adoption: Partner with product teams to automate repetitive revenue cycle tasks through the organization's operating technology and AI-enabled solutions. Apply AI to identify denial patterns, support appeal preparation, improve efficiency, and strengthen analytical capabilities across the team.
Manage a complex payer environment: Oversee revenue cycle performance across commercial insurance plans, Medicare, TRICARE, and VA Community Care, ensuring processes reflect applicable payer policies, authorization requirements, and reimbursement rules.
Ensure operational accountability: Establish consistent performance monitoring, document decisions and processes, and drive continuous improvement across the revenue cycle function.
Maintain a patient-centered approach: Prioritize operational improvements that reduce administrative delays and help patients access appropriate care sooner, while respecting clinical decision-making, patient safety, and individual dignity.