Soris Pain & Vascular Institute
Head of Revenue Cycle Management
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Head of Revenue Cycle Management (RCM)
Job Description
Role: Head of RCM
Industry: Healthcare (Multi-Specialty: Podiatry, Vascular/Vein, & OBL)
Location: Remote
Reports to: Director of Finance
Executive Summary
We are seeking a strategic, data-driven Head of Revenue Cycle Management to oversee the end-to-end financial health of our expanding multi-specialty practice.
This is a rare opportunity to build the revenue cycle function of a national, multi-specialty healthcare organization (Podiatry, Vascular Surgery & Interventional Radiology) from the ground up — with the resources of a well-capitalized parent company and the autonomy of a lean, entrepreneurial team. The Head of RCM will have direct visibility to executive leadership, meaningful influence over platform acquisitions, and the opportunity to architect systems that scale across a growing portfolio of specialty practices.
The ideal candidate is a "builder" who can scale processes, optimize clean claim rates, and navigate the specific regulatory landscapes of surgical and interventional outpatient care.
Core Responsibilities
Strategic Leadership & Scaling
- Design, implement, and continuously improve end-to-end RCM workflows across all specialty platforms, ensuring consistency while preserving the clinical and billing nuances of each service line.
- Define and monitor an org-level KPI dashboard covering First Pass Rate, Net Collection Rate, Denial Rate, Days in A/R, Clean Claim Rate, and Prior Auth approval rates.
- Evaluate, select, and manage third-party billing vendors where applicable; define SLAs, hold vendors accountable, and determine in-source/outsource strategy as the organization scales.
- Build and lead the internal RCM team — hiring, training, and developing billing staff, coders, and AR specialists across subsidiaries.
- Report regularly to the Director of Finance and C-Suite on revenue cycle performance, translating billing data into executive-level narratives with clear recommendations.
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Specialized Revenue Oversight
- OBL & Vascular/IR: Ensure precise capture of high-cost implantable supplies and complex interventional coding (C-arm procedures, atherectomies, thrombectomies, dialysis access, MSK Embolization). Manage facility and professional fee splits. Stay current on CMS Local Coverage Determinations (LCDs) for vascular procedures.
- Podiatry: Optimize high-volume claims processing, including CPT coding accuracy, DME (Durable Medical Equipment) billing, routine vs. non-routine care distinctions, and multi-provider practice management.
- Payer Relations: Lead payor contract negotiations across all subsidiaries to ensure optimal reimbursement rates for specialized procedures. Maintain a comprehensive payer contract library and monitor for mid-year policy changes.
Front-End & Middle-Cycle Excellence
- Oversee prior authorization processes — particularly for vein/vascular procedures and OBL surgeries — implementing systems that minimize preventable denials before claims are submitted.
- Implement robust patient eligibility verification at the point of scheduling and registration.
- Collaborate with clinical staff and EMR administrators to improve documentation quality, coding accuracy, and charge capture timeliness.
- Oversee charge posting, payment posting, and AR appeals workflows; serve as the escalation point for complex billing disputes.
Compliance & Technology
- Ensure 100% compliance with HIPAA, CMS Conditions for Coverage, OIG guidelines, Medicare and Medicaid regulations, and commercial payer policy requirements.
- Maintain and update internal billing policies and procedures in response to regulatory changes; communicate updates to clinical and administrative teams.
- Conduct regular internal audits of claim accuracy, coding appropriateness, and documentation completeness.
- Monitor federal and state legislative changes affecting reimbursement, implement required workflow adjustments, and brief executive leadership on material impacts.
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Technology, Data & Analytics
- Evaluate, implement, and optimize RCM technology platforms — including Practice Management (PM) systems, EHR integrations, clearinghouses, and AI-enabled claims adjudication tools.
- Develop and maintain dashboards and reporting infrastructure that provide real-time visibility into revenue cycle performance at the platform and BSO levels.
- Drive automation of manual billing tasks to improve throughput and reduce human error.
- Leverage data analytics to identify denial patterns, underpayment trends, and revenue leakage — and implement corrective action plans.
Requirements
Candidate Requirements
- Experience: 7+ years in Healthcare RCM leadership. Direct experience with OBL (Office-Based Lab) or ASC (Ambulatory Surgery Center) billing is highly preferred.
- Knowledge: Deep understanding of Podiatry, Vascular/interventional radiology coding and medical necessity requirements.
- Analytical Skills: Advanced proficiency in Excel/BI tools; ability to "tell the story" behind the numbers to the executive board.
- Education: Bachelor’s degree in Healthcare Administration, Finance, or related field. MBA or MHA is a plus.
- Certifications: CPC, COC, or CHFP preferred.
Compensation
- $165,000 – $175,000 base salary, with the ability to go above range for candidates with exceptional experience and proven impact.
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