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Director of Revenue Cycle & Billing

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Job Description - Director of Revenue Cycle & Billing


Ophthalmic Consultants of Boston is current seeking a dynamic Director for our Revenue and Billing group.

We are seeking a strategic and hands-on Director of Revenue Cycle and Billing to oversee and optimize the entire revenue cycle across multiple departments, including Front Desk Operations, Central Scheduling/Call Center, Credentialing, Billing, and Medical Claims Management. This leadership role requires a dynamic professional with deep expertise in healthcare operations, claims submission, payer relations, and staff development.
The successful candidate will lead high-volume operations, ensure compliance with industry standards, drive revenue growth, and foster a culture of excellence and accountability.
Key Responsibilities:
  • Lead and oversee the day-to-day operations of the Revenue Cycle, including Front Desk, Central Scheduling/Call Center, Credentialing, Billing, and Prior Authorization functions.
  • Manage high volumes of inbound and outbound calls, ensuring quality assurance and call center performance metrics are met.
  • Direct the submission of medical claims, denial management, and Accounts Receivable follow-up processes with a strong focus on accuracy and timely reimbursements.  This includes efforts to improve self-pay collections.
  • Oversee prior authorizations and insurance appeal processes, coordinating closely with payers to ensure approval and minimize delays.
  • Ensure accurate use of ICD-10, CPT, and HCPCS coding in collaboration with billing and clinical staff.
  • Hire, train, and supervise revenue cycle billing and front-end teams, promoting continuous development and strong interdepartmental collaboration.  Lead regular training sessions and meetings with managers and staff. 
  • Establish operational benchmarks, KPIs, and performance dashboards to measure efficiency and revenue impact.
  • Work collaboratively with Finance, Compliance, and Clinical Operations to ensure alignment of financial goals and patient satisfaction.
  • Lead initiatives in budgeting, cost reduction, and revenue optimization, using data analytics and financial modeling.
  • Develop and present detailed revenue reports, forecasts, and presentations to executive leadership, offering insight into trends, opportunities, and performance.
  • Ensure adherence to all regulatory requirements, including HIPAA, CMS, and payer-specific guidelines.
  • Support the physicians with billing and reimbursement questions and help develop practice policies related to the revenue cycle.
  • Serve as the key expert in the billing system (Epic Resolute) for staff, physicians, clinical, and administrative team members.
Qualifications:
  • Bachelor’s degree in healthcare administration, Business, Finance, or a related field required
  • 7–10 years of progressive experience in revenue cycle management, including at least 3 years in a director or senior management role.
  • Proven experience managing high-volume patient access and billing operations, including scheduling, call centers, and prior authorizations.
  • Advanced understanding of medical billing procedures, insurance processes, appeals, and payer communications.
  • Strong knowledge of ICD-10, CPT, and medical coding principles.
  • Skilled in staff hiring, training, and leadership with the ability to build and maintain high-performing teams.
  • Demonstrated success in revenue analytics, budget oversight, and implementation of cost-saving measures.
  • Proficiency with EHR and PM systems (e.g., Epic, Athenahealth, eClinicalWorks, NextGen).
  • Excellent communication and presentation skills with the ability to influence across departments and leadership levels.

Benefits Offered:

  • Health & Dental Insurance- eligible 1st day of employment
  • Paid time off and paid holidays
  • Health & Dependent Reimbursement Accounts
  • 401(k) Plan with company contribution
  • Company paid Life and LTD Insurance
  • Employee discounts

To find out more about OCB, please visit our website at www.eyeboston.com. OCB is an Equal Opportunity Employer.


 


 
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