RCM Director

Position: RCM Director

Employment Type: 100% Remote

Employment Status: Independent Contractor

Shift Schedule: US Time Zone

RCM Director – Job Description

Position Summary

The Revenue Cycle Management (RCM) Director is responsible for leading all patient and some insurance‑related revenue cycle operations, including Patient AR Management, Insurance Benefits Verification, patient communications, interaction with patent services, credentialing, product development, and contracting departments. Improve the patient financial journey, communications, patient collections, reduce denials associated with Eligibility and coverage, and improve overall cash collections. This role oversees both internal RCM staff and the outsourced RCM vendor, ensuring consistent execution, compliance, and measurable financial performance.

Key Responsibilities

Patient AR and Credit Balance Management

• Lead and oversee all patient accounts receivable workflows to ensure timely follow‑up, resolution, and cash acceleration.
• Monitor aging trends, patient collections performance, and root causes contributing to delays or non‑payment.
• Implement corrective actions to reduce AR > 90 days and improve overall AR health.
• Develop new processes and reporting to track productivity, recovery, and payer responsiveness.
• Oversee the management of patient credit balances to ensure timely and accurate account review, proper application of credits, and the issuance of refunds to patients when appropriate.
• Develop dashboards and reporting to track productivity, recovery, and payer responsiveness.

Patient Eligibility and Billing Call Center

• Lead the transition of patient eligibility and billing call workflows from Patient Services (COE) to RCM, ensuring continuity of service and operational stability.
• Develop a comprehensive project plan with defined timelines, milestones, and deliverables.
• Create, document, and maintain policies, standard operating procedures (SOPs), and workflow guidelines to support the new call center structure.
• Develop call scripts, communication standards, and staff guidance materials to ensure consistent and accurate patient interactions.
• Build and document decision trees and a robust knowledge base to support staff in resolving eligibility and billing inquiries efficiently.
• Partner with workforce management to ensure staffing models provide full coverage 7 days a week, aligned with call volume and service level expectations.
• Collaborate with cross‑functional teams—including Patient Services (COE),Clinical Ops, RCM leadership, IT/telecom, and training) to ensure successful implementation and ongoing optimization.
• Monitor performance, identify gaps, and drive continuous improvement in call handling, accuracy, and patient satisfaction.

Insurance AR Management

• Collaborate on the accounts receivable workflows to ensure timely follow‑up, resolution, and cash acceleration.
• Help reduce eligibility and coverage denials by implementing automation and working with the third‑party vendor to improve the process.
• Monitor aging trends, payer performance, and root causes contributing to delays or non‑payment.
• Implement corrective actions to reduce AR > 90 days and improve overall AR health.

Denial Reduction & Write‑Off Prevention

• Lead initiatives to reduce preventable denials, including coverage, eligibility, and prior authorizations.
• Analyze denial trends to identify systemic issues and implement targeted interventions.
• Oversee insurance write‑off governance, ensuring write‑offs are appropriate, justified, and minimized.
• Collaborate with clinical, billing, and vendor teams to resolve recurring payer issues.

Training & Change Management

• Schedule, coordinate, and deliver training for internal teams and the RCM vendor on changes to processes.
• Develop training materials, quick‑reference guides, and SOP updates to support operational consistency.
• Ensure all teams understand and implement changes to patient SOPs, Communications, and Collections, especially during periods of regulatory change.

Operational Strategy & Performance Management

• Develop and execute strategies to improve cash flow, reduce AR days, and enhance payer compliance.
• Build and maintain KPI dashboards for AR, denials, write‑offs, and payer turnaround times.
• Lead cross‑functional initiatives with Finance, Compliance, Clinical Operations, and IT to strengthen revenue integrity.
• Identify automation opportunities and partner with technology teams to str