Director, Revenue Cycle
5 days ago
Nashville
Job DescriptionDescription: At Playground Pediatrics, our purpose is simple and powerful: to ensure every child has what they need to grow up healthy, supported, and celebrated. We partner with pediatric practices to strengthen operations, support clinical teams, and improve access to high-quality care within the communities we serve. If you are motivated to shape the future of pediatric healthcare and thrive in a collaborative, mission-driven environment, we would love to have you on our team. Position Summary The Director of Revenue Cycle is responsible for providing strategic leadership and operational oversight across all revenue cycle functions including Accounts Receivable (AR), Charge Entry, Payment Posting, Cash Collections, Front-End Financial Operations, and Denial Management. This role ensures accurate, timely, and compliant revenue cycle performance across all physician practices, drives continuous improvement initiatives, leads revenue cycle managers and billing teams, and partners with executive and market leadership to achieve enterprise KPI targets. Key Responsibilities • Provide enterprise-level oversight, training, and leadership for revenue cycle operations across all markets and EMRs., • Oversee daily AR management with a focus on reducing aged AR and improving overall cash flow., • Lead and manage teams responsible for charge entry, claim edits, payment posting, denial follow-up, and refunds., • Responsible for management and development of Revenue Cycle Managers and Billing Specialists., • Monitor, analyze, and report key revenue cycle KPIs including AR >90 days, NCR, denial rates, TOS collections, and cash projections., • Knowledge of correct E&M coding, AR management, how to solve key denials., • Lead teams in achieving enterprise KPI targets, including a 97% net collection rate and keeping A/R over 90 days below 15%., • Ensure compliance with CMS, payer contracts, and state Medicaid regulations., • Develop, communicate, and enforce corporate revenue cycle policies and procedures., • Serve as executive subject matter expert for Athena Collector, EPIC, and other revenue cycle platforms (ECW, Allscripts, Practice Fusion)., • Oversee implementation, optimization, and utilization of revenue cycle technology and reporting tools., • Recommend workflow enhancements and automation to improve performance and scalability., • Partner with VP of Revenue Cycle, Regional Market Directors, and Finance leadership to align financial workflows., • Develop relationships with external payers, regulatory bodies, and professional organizations., • Train, mentor, and develop revenue cycle leaders and staff to ensure accountability and high performance., • Promote a culture of continuous improvement, compliance, and operational excellence., • Perform other duties as assigned. Requirements:, • Bachelors’ degree, required, • At least 5 years of progressive experience in healthcare revenue cycle with hands-on leadership responsibility, required, • At least 5 years of experience managing and coaching employees, fostering growth, and evaluating performance within revenue cycle teams, required, • Demonstrated expertise across all aspects of the physician practice revenue cycle, required, • Strong analytical skills with advanced Excel proficiency and experience with Power BI or similar data visualization tools, required, • Demonstrated ability to lead teams to achieve KPI and productivity goals and driving measurable results, required, • Strong knowledge of AR management, coding, claims processing, denial management, and cash posting, required, • Certified Professional Coder (CPC) or willingness to obtain certification within the first 90 days, required, • Ability to travel up to 75% within the first year to support team and operational needs, required, • Hands-on experience with Athena, EPIC, eCW, and Allscripts electronic medical records systems, streamlining workflows and optimizing revenue cycle efficiency, • Experience in pediatrics or managing multi-site/multi-state healthcare operations, bringing insight into complex, diverse practice environments This job description is intended to describe the general nature and level of work performed. It is not intended to be an exhaustive list of all duties, responsibilities, or qualifications. The Director of Revenue Cycle may be required to perform additional duties as needed.