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Time Type:

Full time

Department:

Patient Accounts

All Locations:

300 Ocean Avenue – Revere

Position Summary:

The Senior Director of Revenue Cycle provides operational leadership and strategic oversight for NeighborHealth’s revenue cycle functions, ensuring the effective management of billing, coding, accounts receivable, cash posting, credit balance resolution, and collections activities across the organization’s clinical service lines.

This role is responsible for optimizing revenue cycle performance, ensuring compliance with federal and state billing regulations, and strengthening financial sustainability through improved reimbursement accuracy, denial management, and operational efficiency. The Senior Director partners closely with Finance, Operations, Clinical Leadership, IT, and Compliance teams to ensure alignment between clinical documentation, billing workflows, and reimbursement strategies.

The Senior Director will lead a team responsible for daily revenue cycle operations while driving continuous improvement in key performance indicators such as days in accounts receivable, clean claim rate, denial resolution, and net collection rate.

Operating at the intersection of finance, clinical operations, and regulatory compliance, the Senior Director of Revenue Cycle ensures the integrity, efficiency, and performance of the organization’s revenue cycle operations.

The successful candidate will be able to perform the following responsibilities:

Revenue Cycle Operations

• Provide senior level leadership and oversight of all revenue cycle functions including charge capture, coding, billing, collections, payment posting, and accounts receivable management.
• Ensure timely and accurate submission of claims to third-party payers including MassHealth, Medicare, commercial insurers, and other payers.
• Monitor accounts receivable performance and lead initiatives to reduce days in AR, improve collection rates, and minimize write-offs.
• Oversee denial management processes including root-cause analysis, corrective action plans / appeal initiatives, and process improvement initiatives.
• Ensure appropriate internal controls and workflows for billing accuracy and revenue integrity.

Revenue Optimization & Performance Management

• Develop and monitor key revenue cycle performance metrics including clean claim rate, denial rate, days in AR, and net collection rate.
• Produce regular revenue cycle performance reports and dashboards for senior leadership.
• Conduct financial and operational analysis to identify revenue leakage and improvement opportunities.
• Lead initiatives to improve clinical documentation, charge capture accuracy, and claim submission efficiency.

Regulatory Compliance & Billing Integrity

• Ensure compliance with federal and state billing regulations, including Medicare, Medicaid, and MassHealth requirements applicable to Federally Qualified Health Centers.
• Maintain current knowledge of payer regulations, billing guidelines, and reimbursement methodologies.
• Coordinate internal and external billing and coding audits to ensure regulatory compliance and revenue integrity.
• Support organizational readiness for external audits, regulatory reviews, and HRSA operational site visits.

Cross-Functional Collaboration

• Partner with clinical, operational, and administrative leadership to ensure alignment between clinical workflows and billing requirements.
• Collaborate with Information Technology teams to implement system improvements, optimize billing workflows, and support regulatory changes.
• Work closely with department leaders to address incomplete encounters, documentation issues, and charge capture gaps.
• Provide training and educational resources to providers and staff on revenue cycle processes and compliance requirements.

Staff Leadership & Development

• Lead and develop revenue cycle staff through coaching, training, and performance management.
• Establish clear expectations, operational goals, and productivity standards for revenue cycle teams.
• Promote a culture of accountability, collaboration, and continuous improvement within the department.
• Support staff development through ongoing training and professional growth opportunities.

Payer Contract Management

• Lead payer contracting strategy, including negotiation of reimbursement terms with third party payers to optimize revenue and minimize administrative burden.
• Maintain a centralized inventory of all payer contracts, including fee schedules, key terms, and renewal timelines, ensuring accessibility and version control.
• Monitor contract compliance and payer performance, including reimbursement accuracy, denial trends, and adherence to contractual terms.
• Develop processes to identify and recover underpayments, leveraging analytics to compare expected vs. actual reimbursement.
• Partner with Finance and operational leaders to model financial impact, support value-based arrangements (e.g., ACO/SCO), and ensure contract terms are effectively operationalized.

Strategic Initiatives & Organizational Support

• Collaborate with the CFO and senior leadership to support financial planning, revenue forecasting, and reimbursement strategy.
• Assist with analysis of payer reimbursement methodologies and financial impact of regulatory changes.
• Participate in organizational initiatives related to new services, payer contracts, and operational improvements.
• Represent the organization in external meetings, workgroups, or industry forums related to revenue cycle operations.

What You’ll Bring

• Bachelor’s degree in healthcare administration, business administration, finance, or related field required. Master’s degree preferred.
• Minimum of 7–10 years of progressive experience in revenue cycle management within a hospital, community health center, or large physician practice environment.
• Minimum of 3–5 years of leadership or management experience overseeing revenue cycle operations.
• Strong knowledge of healthcare billing, coding, and reimbursement methodologies including Medicare, Medicaid, and commercial payers.
• Familiarity with Federally Qualified Health Center reimbursement models and regulatory requirements strongly preferred.
• Experience managing accounts receivable, billing systems, and revenue cycle performance metrics.
• Proficiency with electronic health record and billing systems such as Epic Resolute or similar platforms preferred.
• Demonstrated ability to analyze complex financial data and translate insights into operational improvements.
• Excellent leadership, communication, and interpersonal skills.
• Strong organizational, analytical, and problem-solving capabilities.
• Commitment to NeighborHealth’s mission of delivering high-quality, community-centered healthcare.

Work Environment & Physical Requirements

• This position operates in a professional office and clinic environment.
• Regularly required to sit, stand, walk, and use hands to operate a computer and other office equipment.
• Must be able to remain in a stationary position for extended periods while performing administrative and computer-based tasks.
• Occasionally required to lift or move items weighing up to 20 pounds (such as files, office supplies, or small equipment).
• Must have adequate visual acuity, hearing, and manual dexterity to perform essential job functions.
• May occasionally move between clinic and administrative areas and be exposed to a typical clinical setting.
• Expected to follow all NeighborHealth and OSHA safety policies and procedures, including maintaining a safe and ergonomic work environment.

Pay Range:

Starts at $141, 440 up to $232, 960 based on experience

EEO & Accommodation Statement:

NeighborHealth is an equal employment/affirmative action employer. We ensure equal employment opportunities for all, without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic. If you need accommodation for any part of the application process because of a medical condition or disability, please send an e-mail to HRrecruit@ NeighborHealth.com or call 617-568-4480 to let us know the nature of your request

Federal Trade Commission Statement:
According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website. We do not ask or require downloads of any applications, or “apps.” Job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

E-Verify Program Participation Statement:

NeighborHealth participates in the Electronic Employment Verification Program, E-Verify. As an E-Verify employer, all prospective employees must complete a background check before beginning employment.