Head of Revenue Cycle Management at CUC AMERICA INC
United States
$165k - $175k
<p>Description</p><p> </p><h3>Head of Revenue Cycle Management</h3><p><br/></p><h3>Description</h3><p>Job Description: Head of Revenue Cycle Management (RCM)</p><p>Role: Head of RCM </p><p>Industry: Healthcare (Multi-Specialty: Podiatry, Vascular/Vein, & OBL)</p><p>Location: Remote</p><p>Reports to: Director of Finance</p><p><br/></p><p><u><strong>Executive Summary</strong></u></p><p>We are seeking a strategic, data-driven Head of Revenue Cycle Management to oversee the end-to-end financial health of our expanding multi-specialty practice. </p><p><br/></p><p>This is a rare opportunity to build the revenue cycle function of a national, multi-specialty healthcare organization (Podiatry, Vascular Surgery & Interventional Radiology) from the ground up — with the resources of a well-capitalized parent company and the autonomy of a lean, entrepreneurial team. The Head of RCM will have direct visibility to executive leadership, meaningful influence over platform acquisitions, and the opportunity to architect systems that scale across a growing portfolio of specialty practices.</p><p><br/></p><p>The ideal candidate is a "builder" who can scale processes, optimize clean claim rates, and navigate the specific regulatory landscapes of surgical and interventional outpatient care.</p><p><br/></p><p><u><strong>Core Responsibilities</strong></u></p><p><br/></p><p><em><u>1. Strategic Leadership & Scaling</u></em></p><p>• Design, implement, and continuously improve end-to-end RCM workflows across all specialty platforms, ensuring consistency while preserving the clinical and billing nuances of each service line.</p><p>• Define and monitor an org-level KPI dashboard covering First Pass Rate, Net Collection Rate, Denial Rate, Days in A/R, Clean Claim Rate, and Prior Auth approval rates.</p><p>• Evaluate, select, and manage third-party billing vendors where applicable; define SLAs, hold vendors accountable, and determine in-source/outsource strategy as the organization scales.</p><p>• Build and lead the internal RCM team — hiring, training, and developing billing staff, coders, and AR specialists across subsidiaries.</p><p>• Report regularly to the Director of Finance and C-Suite on revenue cycle performance, translating billing data into executive-level narratives with clear recommendations.</p><p><br/></p><p><em><u>2. Specialized Revenue Oversight</u></em></p><p>• OBL & Vascular/IR: Ensure precise capture of high-cost implantable supplies and complex interventional coding (C-arm procedures, atherectomies, thrombectomies, dialysis access, MSK Embolization). Manage facility and professional fee splits. Stay current on CMS Local Coverage Determinations (LCDs) for vascular procedures. </p><p>• Podiatry: Optimize high-volume claims processing, including CPT coding accuracy, DME (Durable Medical Equipment) billing, routine vs. non-routine care distinctions, and multi-provider practice management. </p><p>• Payer Relations: Lead payor contract negotiations across all subsidiaries to ensure optimal reimbursement rates for specialized procedures. Maintain a comprehensive payer contract library and monitor for mid-year policy changes. </p><p><br/></p><p><em><u>3. Front-End & Middle-Cycle Excellence</u></em></p><p>• Oversee prior authorization processes — particularly for vein/vascular procedures and OBL surgeries — implementing systems that minimize preventable denials before claims are submitted.</p><p>• Implement robust patient eligibility verification at the point of scheduling and registration.</p><p>• Collaborate with clinical staff and EMR administrators to improve documentation quality, coding accuracy, and charge capture timeliness.</p><p>• Oversee charge posting, payment posting, and AR appeals workflows; serve as the escalation point for complex billing disputes.</p><p><br/></p><p><em><u>4. Compliance & Technology</u></em></p><p>• Ensure 100% compliance with HIPAA, CMS Conditions for Coverage, OIG guidelines, Medicare and Medicaid regulations, and commercial payer policy requirements.</p><p>• Maintain and update internal billing policies and procedures in response to regulatory changes; communicate updates to clinical and administrative teams.</p><p>• Conduct regular internal audits of claim accuracy, coding appropriateness, and documentation completeness.</p><p>• Monitor federal and state legislative changes affecting reimbursement, implement required workflow adjustments, and brief executive leadership on material impacts.</p><p><br/></p><p><em><u>5. Technology, Data & Analytics</u></em></p><p>• Evaluate, implement, and optimize RCM technology platforms — including Practice Management (PM) systems, EHR integrations, clearinghouses, and AI-enabled claims adjudication tools.</p><p>• Develop and maintain dashboards and reporting infrastructure that provide real-time visibility into revenue cycle performance at the platform and BSO levels.</p><p>• Drive automation of manual billing tasks to improve throughput and reduce human error.</p><p>• Leverage data analytics to identify denial patterns, underpayment trends, and revenue leakage — and implement corrective action plans.</p><h3><br/></h3><p>Requirements</p><p><strong> </strong><u><strong>Candidate Requirements</strong></u></p><ul><li>Experience: 7+ years in Healthcare RCM leadership. Direct experience with OBL (Office-Based Lab) or ASC (Ambulatory Surgery Center) billing is highly preferred.</li><li>Knowledge: Deep understanding of Podiatry, Vascular/interventional radiology coding and medical necessity requirements.</li><li>Analytical Skills: Advanced proficiency in Excel/BI tools; ability to "tell the story" behind the numbers to the executive board.</li><li>Education: Bachelor’s degree in Healthcare Administration, Finance, or related field. MBA or MHA is a plus.</li><li>Certifications: CPC, COC, or CHFP preferred.</li></ul><p><strong>Compensation:</strong> $165,000 – $175,000 base salary, with the ability to go above range for candidates with exceptional experience and proven impact. </p>
Apply Now
