Director of Revenue Cycle

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The Director of Revenue Cycle is accountable for the end-to-end financial performance of PCOM's clinical revenue cycle, from patient access through cash reconciliation. This role ensures revenue integrity across a diverse, multi-site clinical enterprise that includes primary care, geriatrics, osteopathic manipulation (OMM), behavioral health, and satellite locations.
This position serves as the primary owner of revenue cycle strategy, operations, and vendor governance, including direct oversight of the external billing partner (EMP Claims) and payer performance. The Director partners closely with Finance, Clinical Leadership, Practice Operations, and IT to improve performance, standardize workflows, and support growth.

Revenue Cycle Leadership & Ownership

• Own the end-to-end revenue cycle across all PCOM clinical sites and service lines
• Establish consistent front-end and back-end revenue workflows
• Identify, quantify, and remediate revenue leakage
• Ensure timely, accurate, and compliant billing and collections
• Ensure revenue cycle processes align with applicable payer requirements, including Medicare, Medicaid, and relevant federal regulations
• Provide oversight and guidance for patient access and scheduling workflows to ensure eligibility verification and registration accuracy support clean claims

Vendor Governance & Performance Management

• Serve as the primary relationship owner for the external billing partner (EMP Claims)
• Define and manage SLAs, KPIs, and performance expectations
• Lead regular vendor performance reviews and escalation processes
• Distinguish root causes between documentation issues, operational breakdowns, vendor execution, and payer behavior
• Recommend vendor or contract changes when performance does not meet expectations

Payer Contract Insight & Revenue Integrity

• Interpret payer contracts to ensure accurate reimbursement and identify underpayment trends
• Partner with Finance to assess financial impact of payer terms and reimbursement methodologies
• Support evaluation of payer performance and inform contract strategy and renegotiation priorities

Financial Performance & Reporting

• Own and monitor key revenue cycle metrics, including:
  • Days in Accounts Receivable
  • Denial rate and denial root causes
  • Net collection percentage
  • Charge lag and claim submission timeliness
• Develop leadership-ready dashboards and insights, not just raw reports
• Translate revenue data into actionable recommendations for Finance and Executive Leadership

Clinical & Operational Partnership

• Partner with clinical leadership to improve documentation and coding accuracy, including faculty and learner environments
• Support service-line specific needs (e.g., OMM, geriatrics, nursing home services)
• Collaborate with practice operations to improve front-desk workflows, eligibility verification, and registration accuracy
• Serve as a trusted advisor across Finance, Operations, and Clinical teams

Revenue Cycle Strategy & Readiness

• Prepare revenue cycle infrastructure for:
  • New sites and satellite locations
  • New or evolving service lines
  • Changes in payer mix or reimbursement models
• Support evaluation and potential transition of cash-pay services to insurance-based models (e.g., behavioral health)
• Develop a 12-18-month revenue cycle roadmap aligned to PCOM's clinical growth strategy

Qualifications & Experience

Required

• Experience in healthcare revenue cycle operations, preferably in a multi-site or multi-service environment
• Strong understanding of end-to-end revenue cycle workflows, including charge capture, coding, billing, and collections
• Working knowledge of CPT, ICD-10, and reimbursement methodologies sufficient to identify documentation, coding, and payment issues
• Demonstrated experience managing or overseeing a third-party billing partner
• Experience working within an electronic medical record (EMR) environment to support revenue cycle operations; familiarity with NextGen a plus
• Experience interpreting payer contracts and reimbursement methodologies to support revenue cycle performance
• Ability to identify underpayments and contract variances through data analysis
• Ability to translate complex revenue data into actionable insights
• Strong cross-functional communication and influence skills

Preferred

• Experience in academic medical, ambulatory, or mixed clinical environments
• Familiarity with primary care, geriatrics, or procedure-based services (e.g., OMM)
• Experience supporting growth or operational transformation initiatives

Starting Salary:$130,000.00 annually

The referenced salary range is based on PCOM good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level. PCOM offers a total rewards package that supports our employees' health, life, career and retirement.

PCOM prohibits discrimination on the basis of age, race, sex, color, gender, gender identity and expression, national origin, ethnicity, ancestry, sexual orientation, religion, creed, disability, genetic information, marital status, pregnancy, military and military veteran status or any other legally protected class status in all its programs, activities, and employment practices.