Director, Revenue Cycle Mangement

South Plainfield, New Jersey

Type: Direct-Hire

Category: Accounting & Finance

Compensation Range: 100000.00 - 150000.00

Job ID: 158526

Date Posted: 01/13/2021

Director, Revenue Cycle Management wanted for rapidly growing company in So. Plainfield!

Purpose of the Position:
Responsible for management and support of enterprise-wide revenue cycle for billing and reimbursement. Compliance officer responsible for ensuring full Federal and State Compliance.


  • Directs and oversees the overall policies, objectives, and initiatives of the organization’s revenue cycle activities to optimize reimbursement and ensure compliance
  • Works with upper management/leadership team regularly to discuss plans of action, issues,best practices, and compliance
  • Assesses and makes recommendations to improve efficiency of current systems/processes for the entire Revenue Cycle
  • Be the main contact point as it pertains to any revenue cycle management questions, concerns,updates.
  • Prepare monthly revenue cycle reports
  • Manages the internal billing staff
  • Reviews, designs, and implements processes surrounding billing, pricing, third party pay relations, compliance, collections and other financial analyses to ensure that revenue cycle is effective and properly utilized
  • Identify and analyze reimbursement trends to advise Upper Management and internal stakeholders accordingly
  • Perform prospective and retrospective chart audits, reviewing for accuracy and compliance
  • Work closely with billing vendor and reimbursement staff to address billing issues and streamline workflows
  • Work closely with Internal and External Sales Groups to ensure proper guidelines are followed and ensure any questions or concerns as they relate to billing and reimbursement are handled in a timely and efficient manner
  • Investigate billing issues due to potentially inappropriate documentation, coding, and/or medical necessity
  • Follow up with the referring physician offices and/or Internal/External Sales Groups to ensure corrective actions are taken
  • Investigate, evaluate, recommend, and implement coding and fee updates
  • Negotiate contracts with payers based on needs of the company
  • Perform other administrative and supervisory duties as assigned


  • Bachelor’s Degree or relevant experience required
  • Coding certification required
  • 10+ years’ experience Staff Management
  • 10+ years’ experience hands on billing & coding required
  • Strong understanding of the Revenue Cycle and ability to manage each aspect of it
  • Compliance Officer experience a plus
  • Experience in a molecular / genomics lab highly preferred
  • Audit Certificate highly preferred
  • Strong understanding of the Medical/Laboratory Billing Process and Industry Standard
  • Exceptional Knowledge of ICD’s, CPT’s, and LCD’s.
  • Must possess strong knowledge of EOB’s and ERA’s with the ability to read and understand the follow-up steps required to mitigate any issues that need attention
  • Successful track record of negotiating with insurance companies to be brought in-network
  • Highly proficient in Microsoft Office, specifically Excel
  • Excellent interpersonal, verbal, and written communication skills
  • Ability to multitask and manage several projects concurrently
  • Ability to think outside the box

Excellent benefits package!  
Salary $100-$150k