Revenue Cycle Management Director

Summary

Join Brightline as their Director of Revenue Cycle Management to build and grow their revenue cycle function. You will oversee end-to-end Revenue Cycle Management, including eligibility verification, claims submission, denial management, cash applications, and reporting. This role demands strategic leadership and execution, requiring hands-on involvement in daily operations while developing scalable systems. You will drive revenue growth, ensure regulatory compliance, and analyze key performance metrics to improve operational efficiency. The position starts as a team of one, with the opportunity to build and lead a team of medical coding and billing specialists. You will collaborate with various teams, including finance, product, operations, partnerships, and clinical teams.

Requirements

• 7+ years of hands-on revenue cycle experience, ideally within a startup or fast-growing environment
• Scrappy, resourceful problem solver who thrives in a startup environment with limited resources but a big vision
• Data-driven with a strong focus on revenue cycle metrics and process improvement
• Collaborative communicator who enjoys working across teams and has the ability to train and coach others as we scale
• Passionate about healthcare, particularly pediatric mental health, and excited to contribute to a transformative mission
• Comfortable in a fast-moving, constantly evolving environment with a flexible, can-do attitude
• Passionate about building in a high-growth, fast-paced environment
• Loves a challenge and can think on your feet, finding creative solutions to problems as they arise
• Excited about driving both strategy and execution in a scrappy, startup environment
• Ability to work independently while also contributing to a larger, collaborative team effort

Responsibilities

• Optimize RCM Infrastructure: Develop and implement scalable, best-in-class revenue cycle processes to support the company’s growth and improve operational efficiency
• Optimize claims processing, coding accuracy, charge capture, and collections workflows to reduce denials and accelerate reimbursements
• Refine standardized policies, procedures, and best practices across the revenue cycle, from patient intake to final collections
• Drive Measurable Performance Gains: Analyze key performance metrics, including denial rates, net collection rate, AR days, and cash flow trends, ensuring proactive issue resolution and continuous process improvements
• Oversee a structured denials management program, focusing on root cause identification, appeals success, and process refinements to minimize preventable denials
• Drive collection rate improvements by enhancing payer communications, optimizing patient billing processes, and improving financial transparency
• Ensure timely and accurate claim submissions, reducing A/R aging and bad debt exposure while improving reimbursement timelines
• Strengthen Reporting & Data-Driven Decision-Making: Establish a structured reporting cadence, providing leadership with clear visibility into RCM performance, financial risks, and opportunities for improvement
• Analyze payer performance, reimbursement trends, and claim adjudication patterns to optimize revenue recovery strategies
• Leadership & Cross-Functional Collaboration: Start as a team of one, with the opportunity to build, scale, and lead a team of medical coding and billing specialists as we grow
• Serve as the primary point of contact for RCM, providing clear direction and insights across finance, product, operations, partnerships, and clinical teams
• Partner with finance and accounting to align on forecasting, revenue recognition, and cash flow optimization
• Work closely with product and engineering to identify and implement tech-enabled solutions that enhance RCM efficiency
• Collaborate with operations to ensure seamless patient billing, eligibility verification, and provider credentialing
• Audits & Compliance: Conduct regular compliance audits, ensure accuracy, and stay ahead of coding regulation changes to mitigate compliance risks

Preferred Qualifications

• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
• Experience working in telehealth or with telehealth companies
• Experience working in in-person mental health clinics
• Experience with Candid Health and other healthcare technology platforms
• Expertise in coding for mental and behavioral health
• Familiarity with 270/271 X12 files (real-time eligibility) and experience working with JIRA and engineering teams

Benefits

• Medical, Dental, Vision, Long-Term Disability, Life Insurance, Flexible Spending Account, and 401k
• 14 Company Holidays, flexible time off, paid sick days, parental leave
• Health and Wellness Stipend and Professional Development Reimbursement