Revenue Cycle Management Director

Summary

Join Brightline as their Director of Revenue Cycle Management and build their revenue cycle function from the ground up. You will strategically lead and execute end-to-end RCM, including eligibility, claims, denials, and reporting. This role demands hands-on involvement in daily operations while developing scalable systems. You will analyze key performance metrics, improve processes, and ensure compliance. You will also collaborate with various teams, build a team, and implement tech solutions. The ideal candidate has 7+ years of RCM experience, thrives in a startup environment, and is passionate about pediatric mental health.

Requirements

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

Responsibilities

• 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
• 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
• 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
• 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
• Conduct regular compliance audits, ensure accuracy, and stay ahead of coding regulation changes to mitigate compliance risks

Preferred Qualifications

• 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