Job Description

We are seeking a Director of Revenue Cycle Management (RCM) with proven expertise in behavioral health billing, specifically within substance use disorder (SUD) treatment and mental health treatment This leader will oversee and optimize the full revenue cycle across multi-state operations, ensuring strong cash flow performance, clean claims, and accurate reimbursement across a variety of third-party payors

This is a highly visible role requiring a hands-on leader who understands the realities of behavioral health reimbursement, medical necessity, authorization workflows, claim edits, denials, and payor compliance across multiple states.

What You’ll Own (Core Responsibilities)

Revenue Cycle Leadership

• Lead end-to-end RCM operations including eligibility, authorizations, charge capture, claim submission, denial management, appeals, payment posting, patient AR, and collections

• Own revenue cycle outcomes across multi-state billing environments, ensuring consistency while adapting to state-specific requirements and payor nuances.

• Drive measurable improvement in days in AR, clean claim rate, denial rate, cash acceleration, and net collection rate

3rd Party Billing Expertise

• Manage and optimize billing processes for commercial insurance, Medicaid/Medicare (as applicable), and other third-party payors

• Ensure accurate billing for behavioral health levels of care such as:

  • Detox

  • Residential

  • PHP

  • IOP

  • Outpatient

  • MAT services (where applicable)

Denials + Appeals Strategy

• Build a denial prevention culture through strong front-end workflows (eligibility, auth, documentation readiness).

• Oversee denial workflows including:

  • Root cause analysis

  • Corrective action plans

  • Appeals and peer-to-peer support coordination

• Develop reporting that identifies denial trends by payor, location, clinician/program, diagnosis, and level of care

Compliance + Accuracy

• Ensure compliance with payor contracts, billing rules, documentation standards, and internal controls.

• Maintain strong oversight of behavioral health-specific billing requirements including:

  • medical necessity alignment

  • authorization timelines

  • concurrent review coordination (where applicable)

  • appropriate coding and modifier usage

Team Leadership + Cross-Functional Collaboration

• Lead, mentor, and hold accountable billing/collections teams and/or outsourced RCM partners.

• Partner closely with:

  • Admissions

  • Utilization Review (UR)

  • Clinical leadership

  • Finance

  • Operations

• Improve communication between clinical and billing functions to reduce preventable revenue leakage.

RCM Systems + Reporting

• Oversee billing systems and workflows including EMR/RCM tools such as:

  • Kipu, Sunwave, Valant, NextGen, Athena, AdvancedMD, etc. (experience may vary)

• Create executive-level dashboards and reporting for leadership including:

  • AR aging breakdowns

  • cash collections forecasting

  • payor performance scorecards

  • write-off trends and underpayment detection

What Success Looks Like (Performance Outcomes)

Within the first 90–120 days, you will:

• Identify the top 3–5 revenue leakage areas and implement corrective plans

• Improve billing velocity and reduce AR stagnation

• Strengthen authorization and documentation alignment to reduce denials

• Build clearer payor reporting and accountability

• Establish consistent multi-state billing standards and workflows

Required Experience

• 5+ years of progressive experience in Revenue Cycle Management, including leadership responsibility

• Behavioral health billing experience is required, specifically in:

  • Substance Abuse Treatment

  • Mental Health Treatment

• Proven experience with multi-state billing operations

• Strong expertise in third-party insurance billing

• Deep knowledge of:

  • claims lifecycle

  • denial management

  • appeals processes

  • payor portal workflows and reimbursement practices

Preferred Qualifications (Strongly Desired)

• Experience working in a treatment environment with multiple levels of care (Detox/Res/PHP/IOP)

• Experience managing outsourced billing vendors OR scaling an in-house billing team

• Strong working knowledge of payer contracting impacts on reimbursement (not necessarily a contracting role, but must understand it)

• Familiarity with behavioral health billing challenges such as:

  • frequent recert requirements

  • concurrent review delays

  • medical necessity disputes

  • varying state Medicaid requirements

• Advanced reporting ability (Excel required; BI tools a plus)

Key Skills & Traits

• Strong operator mindset: process-driven, accountable, metrics-focused

• Ability to lead cross-functional change without creating friction

• High attention to detail with the ability to zoom out strategically

• Comfortable owning performance numbers and presenting to leadership

• Calm under pressure and able to solve problems fast when cash is at risk

Why This Role

• High-impact leadership position with direct influence on cash flow and operational stability

• Opportunity to build scalable RCM structure across a growing multi-state platform

• Mission-driven environment supporting individuals and families in recovery and mental health care