Director of Revenue Cycle Management

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    "description": "<p>Position Overview&nbsp;</p>\n\n<p>OrthoMed Anesthesia is&nbsp;seeking&nbsp;a strategic, hands-on&nbsp;Director of Revenue Cycle Management (RCM)&nbsp;to lead and&nbsp;optimize&nbsp;all aspects of anesthesia billing operations. This critical leadership role&nbsp;is responsible for&nbsp;the full RCM cycle, with a specialized focus on anesthesia-specific complexities such as concurrency, medical direction, modifier usage, and payer compliance.&nbsp;</p>\n\n<p>The Director will collaborate across departments&mdash;including clinical, IT, and executive leadership&mdash;to ensure financial accuracy, regulatory compliance, and operational efficiency across a growing network of providers and facilities.&nbsp;</p>\n\n<p><img alt=\"Shape\" src=\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAYAAAAfFcSJAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjwv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAANSURBVBhXY2BgYGAAAAAFAAGKM+MAAAAAAElFTkSuQmCC\" />&nbsp;</p>\n\n<p>Key Responsibilities&nbsp;</p>\n\n<ul>\n\t<li>\n\t<p>Develop and implement RCM strategies to reduce days in A/R, improve cash flow, and minimize denials&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Oversee all components of the RCM process: billing, coding, charge posting, appeals, and patient financial services&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Monitor key performance indicators (KPIs) and produce actionable reports to inform decision-making&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Direct accounts receivable inventory management strategies, including prioritization frameworks, aging bucket oversight, and productivity benchmarks to maximize collections velocity and minimize revenue leakage&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Oversee payer payment variance analysis, ensuring contractual underpayments are&nbsp;identified, documented, and recovered through systematic reconciliation of expected versus actual reimbursement across all payer contracts&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Lead comprehensive denial management and claims appeals programs,&nbsp;establishing&nbsp;root-cause analysis workflows, appeal letter standards, and escalation paths to reduce denial rates and maximize overturn success&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Manage charge correction processes and systematic follow-up on &ldquo;No Activity&rdquo; claims, ensuring&nbsp;timely&nbsp;resolution of suspended, rejected, or unworked accounts before filing deadlines are compromised&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Drive revenue assurance initiatives and&nbsp;maintain&nbsp;expert-level knowledge of No Surprises Act (NSA) compliance, Independent Dispute Resolution (IDR) eligibility and jurisdictional requirements, and applicable state surprise billing regulations to protect net revenue&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Leverage technology solutions to enhance post-bill efficiency, including agentic AI tools for intelligent A/R prioritization and workflow automation, and automated appeals platforms to accelerate denial resolution and reduce manual intervention&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Lead, mentor, and scale a team of onshore and offshore RCM personnel&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Collaborate with credentialing, compliance, and IT teams to&nbsp;optimize&nbsp;workflows and integrations&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Serve as the internal expert on anesthesia billing regulations and payer-specific requirements&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Identify&nbsp;revenue trends and proactively address compliance risks&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Support internal audits, payer negotiations, and staff training initiatives&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Perform&nbsp;additional&nbsp;duties as needed in alignment with OrthoMed Anesthesia&rsquo;s mission&nbsp;</p>\n\t</li>\n</ul>\n\n<p>Required Qualifications&nbsp;</p>\n\n<ul>\n\t<li>\n\t<p>Bachelor&rsquo;s degree in Healthcare Administration, Finance, or equivalent professional experience&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Minimum 5 years of progressive RCM leadership, with a strong background in physician-based billing&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Deep understanding of CPT coding, ASA modifiers, concurrency rules, time documentation, and payer policies&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Knowledge of federal compliance standards, including CMS regulations&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Demonstrated experience designing and&nbsp;optimizing&nbsp;payment tracking and patient accounting workflows, including payment posting reconciliation, contractual adjustment controls, patient balance resolution, and financial clearance processes&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Working knowledge of or hands-on experience with agentic AI solutions for post-bill operations and automated appeals platforms, including AI-driven A/R work queues, intelligent denial routing, and automated payer correspondence&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Demonstrated success in team leadership, change management, and driving performance improvements&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Strong communication&nbsp;and analytical skills; experience with business intelligence (BI) tools is a plus&nbsp;</p>\n\t</li>\n</ul>\n\n<p>Preferred Qualifications&nbsp;</p>\n\n<ul>\n\t<li>\n\t<p>AAPC, HFMA, or CRCM certification&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Experience with anesthesia-specific platforms (e.g., KAM,&nbsp;MedSuite, PPM, or PHI)&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Familiarity with Medicare, Medicaid, and major commercial payer billing guidelines&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Understanding of No Surprises Act (NSA), Independent Dispute Resolution (IDR), and Texas Department of Insurance (TDI) regulations&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Operational experience managing NSA/IDR submissions, including eligibility determinations, offer calculations, certified IDR entity coordination, and jurisdictional compliance across federal and state surprise billing frameworks&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Experience implementing or overseeing automated appeals management platforms and agentic AI tools integrated with anesthesia billing systems for denial resolution, payer correspondence, and post-bill workflow orchestration&nbsp;</p>\n\t</li>\n</ul>\n\n<p><img alt=\"Shape\" src=\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAYAAAAfFcSJAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjwv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAANSURBVBhXY2BgYGAAAAAFAAGKM+MAAAAAAElFTkSuQmCC\" />&nbsp;</p>\n\n<p>Why Join OrthoMed Anesthesia?&nbsp;</p>\n\n<p>At OrthoMed, we are committed to building a forward-thinking anesthesia group rooted in transparency, compliance, and exceptional patient care. As part of our leadership team,&nbsp;you&rsquo;ll&nbsp;receive:&nbsp;</p>\n\n<ul>\n\t<li>\n\t<p>Competitive salary with performance-based bonus opportunities&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Comprehensive health, dental, and vision insurance&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>401(k) plan with 3% non-discretionary company contribution&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>Paid holidays, PTO, and professional development support&nbsp;</p>\n\t</li>\n</ul>\n\n<ul>\n\t<li>\n\t<p>A collaborative and growth-oriented work environment&nbsp;</p>\n\t</li>\n</ul>\n\n<p>&nbsp;</p>\n\n<div>\n<ul>\n</ul>\n</div>\n",
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