Director of Revenue Cycle Management
OMS MEDICAL BILLING LLC · omsmedicalbilling.com
AddisonDirector5+ yrs
Straight from the company’s own careers site.
The job in short
Revenue cycle management leadership.
AgenticAccountingClinicalCompliance
Details
- Found
- 30 d ago · posted 2025-12-08
- Location
- ADDISON, TX, USA
Full description
Job Details: Job Location: Addison Billing Entity - ADDISON, TX, Position Type: Full Time, Salary Range: Undisclosed, Job Shift: Day, Position Overview
OrthoMed Anesthesia is seeking a strategic, hands-on Director of Revenue Cycle Management (RCM) to lead and optimize all aspects of anesthesia billing operations. This critical leadership role is responsible for the full RCM cycle, with a specialized focus on anesthesia-specific complexities such as concurrency, medical direction, modifier usage, and payer compliance.
The Director will collaborate across departments—including clinical, IT, and executive leadership—to ensure financial accuracy, regulatory compliance, and operational efficiency across a growing network of providers and facilities.
Key Responsibilities
Develop and implement RCM strategies to reduce days in A/R, improve cash flow, and minimize denials
Oversee all components of the RCM process: billing, coding, charge posting, appeals, and patient financial services
Monitor key performance indicators (KPIs) and produce actionable reports to inform decision-making
Direct accounts receivable inventory management strategies, including prioritization frameworks, aging bucket oversight, and productivity benchmarks to maximize collections velocity and minimize revenue leakage
Oversee payer payment variance analysis, ensuring contractual underpayments are identified, documented, and recovered through systematic reconciliation of expected versus actual reimbursement across all payer contracts
Lead comprehensive denial management and claims appeals programs, establishing root-cause analysis workflows, appeal letter standards, and escalation paths to reduce denial rates and maximize overturn success
Manage charge correction processes and systematic follow-up on “No Activity” claims, ensuring timely resolution of suspended, rejected, or unworked accounts before filing deadlines are compromised
Drive revenue assurance initiatives and maintain 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
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
Lead, mentor, and scale a team of onshore and offshore RCM personnel
Collaborate with credentialing, compliance, and IT teams to optimize workflows and integrations
Serve as the internal expert on anesthesia billing regulations and payer-specific requirements
Identify revenue trends and proactively address compliance risks
Support internal audits, payer negotiations, and staff training initiatives
Perform additional duties as needed in alignment with OrthoMed Anesthesia’s mission
Required Qualifications
Bachelor’s degree in Healthcare Administration, Finance, or equivalent professional experience
Minimum 5 years of progressive RCM leadership, with a strong background in physician-based billing
Deep understanding of CPT coding, ASA modifiers, concurrency rules, time documentation, and payer policies
Knowledge of federal compliance standards, including CMS regulations
Demonstrated experience designing and optimizing payment tracking and patient accounting workflows, including payment posting reconciliation, contractual adjustment controls, patient balance resolution, and financial clearance processes
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
Demonstrated success in team leadership, change management, and driving performance improvements
Strong communication and analytical skills; experience with business intelligence (BI) tools is a plus
Preferred Qualifications
AAPC, HFMA, or CRCM certification
Experience with anesthesia-specific platforms (e.g., KAM, MedSuite, PPM, or PHI)
Familiarity with Medicare, Medicaid, and major commercial payer billing guidelines
Understanding of No Surprises Act (NSA), Independent Dispute Resolution (IDR), and Texas Department of Insurance (TDI) regulations
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
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
Why Join OrthoMed Anesthesia?
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, you’ll receive:
Competitive salary with performance-based bonus opportunities
Comprehensive health, dental, and vision insurance
401(k) plan with 3% non-discretionary company contribution
Paid holidays, PTO, and professional development support
A collaborative and growth-oriented work environment
Qualifications:
Executive / Director jobs in Addison, Texas · Executive / Director jobs in the United States · All OMS MEDICAL BILLING LLC jobs