Director of Revenue Cycle

Revenue Cycle Operations Management

• Direct, evaluate and optimize all billing and revenue cycle activities for PPWP, including management of staff, and oversight of revenue cycle activities.
 

Financial Performance and Analytics

 

• Develop and maintain reporting and dashboards to monitor key revenue cycle metrics including AR days, denial rates, clean claim rates, collections performance, and payer-specific trends.
• Prepare and present revenue cycle performance reviews to executive leadership.

 

Coding Compliance and Education

 

• Develop and deliver clinical billing and training content for providers and clinical front-end users; coordinate with Medical Services leadership to ensure consistent coding and documentation practices across the organization.
• Act as the primary liaison between the billing department and internal departments ensuring clear communication, updates to billing processes and procedures, identification of trends, issue resolution, and continuous workflow improvement
• Collaborate with Health Center Managers and Medical Services leadership to optimize front-end revenue cycle processes including patient registration, insurance verification, eligibility checking, sliding fee scale application, and point-of-service collections

 

Auditing Compliance and Grants Support

 

• Ensure all billing activities comply with federal and state regulations, HIPAA privacy and security requirements, payer contract terms, and Planned Parenthood’s organizational standards and mission
• Collaboratively review the coding audits with operations and IT analysts to identify training and system enhancements to improve compliant billing and coding.
• Support billing and documentation requirements for the Title X Family Planning Program, including sliding fee scale compliance, service coding, and federal reporting obligations

 

Payer Relations and Contract Management Support

 

• Direct third-party payer contract negotiations, management, and payer relations, including MCO contracts, fee schedule reviews, and dispute resolution.
• Ensure complete, accurate, and timely data is maintained in Epic and that internal operations supports clean claim submission; identify and resolve data or workflow gaps that impact billing performance

 

Strategy and Special projects

 

• Actively participate in strategic discussions and planning activities in collaboration with the Chief Financial Officer and Chief Executive Officer.
• Manage Revenue Cycle Work Plan and actively execute various projects and initiatives identified in prior Revenue Cycle assessments, approved work plan and identified priorities.
• Manage the risk assessment and quality management process and activities of the Revenue Cycle, including the following:
• • Revenue optimization initiatives and needs for PPWP team
  • Evaluation of risk areas, including mitigation of identified risks
  • Actively participate in any financial and other compliance audits, specifically related to Revenue Cycle. 
  • Liaise with other PA affiliates to strategize state-wide revenue enhancement

   

  Staff Leadership and Development

   

  • Recruit, onboard, develop, and retain a small revenue cycle team; set clear performance expectations and conduct regular performance evaluations
  • Foster a culture of accountability, continuous improvement, and mission alignment within the revenue cycle function
  • Perform other duties as assigned by the Chief Financial Officer
   

Bachelor’s degree in Accounting, Finance, Healthcare Administration, Business, or a related field preferred; equivalent combination of experience and education considered.

Minimum of three (3) years in a leadership or director-level role

Minimum of two (2) years of direct, hands-on experience with Epic Resolute Professional Billing required.

Experience in reproductive health, family planning, community health center (FQHC), or women’s health settings strongly preferred