Offer summary

Qualifications:

Bachelor’s degree in healthcare administration, business, or related field required., Minimum of 10 years of revenue cycle management experience; at least 7 years of medical billing experience required., CPC Certification through AAPC preferred; experience with EPIC strongly preferred., Extensive experience in negotiating and managing Managed Care Contracts required..

Key responsabilities:

Direct daily operations of the revenue cycle function, including coding, billing, and accounts receivable management.

Lead and manage revenue cycle staff, including hiring, training, and performance evaluation.

Collaborate with the CEO and COO to improve operational efficiency and customer service.

Monitor departmental KPIs and ensure compliance with federal, state, and payer regulations.

Job description

About Us
Genesis Orthopedics & Sports Medicine is a premier provider of high-quality orthopedic care and sports medicine services. Our mission is to deliver innovative, compassionate, and cutting-edge treatments that help patients recover, perform, and thrive. We are committed to making top-tier orthopedic care accessible to all, challenging the status quo with bold innovation and patient-centered solutions.

Summary/Objective:

The Director of Revenue Cycle will direct daily operations of the revenue cycle function, including coding, medical billing, payment posting, accounts receivable management, workers' compensation, medical records, and disability management. Focusing on maximizing cash flow, ensuring accurate billing, enhancing patient and provider satisfaction, and strategic oversight of revenue optimization, including negotiation and management of Managed Care Contracts in an orthopedic practice setting.

Essential Job Functions:

Oversees coding, billing, payment posting, accounts receivable follow-up, denial management, and reimbursement processes.

Leads and manages onshore and offshore revenue cycle staff, including hiring, training, performance evaluation, and motivation.

Collaborates closely with the CEO and COO to streamline processes, improve operational efficiency, and deliver exceptional customer service.

Reports directly to the COO.

Monitors and ensures departmental KPIs meet or exceed industry standards.

Provides regular training and education to revenue cycle staff and healthcare providers.

Identifies and resolves issues impacting the revenue cycle promptly.

Manages timely and effective denial management and appeals processes.

Maintains updated knowledge of payer policies, regulatory changes, and ensures compliance across the team.

Ensures accurate and timely month-end closing processes.

Conducts periodic internal reviews of claim workflows for continuous improvement and compliance.

Manages revenue cycle-related projects and initiatives.

Ensures departmental activities comply with federal, state, and payer regulations, including HIPAA and OSHA standards.

Coordinates internal and external audits related to billing practices.

Attends management meetings and implements improvements based on audit outcomes.

Leads strategic revenue initiatives, including the negotiation and oversight of Managed Care Contracts with payers.

Analyzes payer contracts regularly to ensure compliance and maximize reimbursement.

Serves as primary liaison with payer representatives, addressing contract-related issues, and negotiating favorable terms.

Develops and implements strategies to optimize payer relationships and improve overall revenue.

Performs other duties as assigned.

Requirements

Requirements:

Education: Bachelor’s degree in healthcare administration, business, or related field required. CPC Certification through AAPC preferred.

Experience: Minimum of 10 years of revenue cycle management experience; at least 7 years of medical billing experience required. Experience with EPIC strongly preferred. Orthopedic or surgical practice experience preferred. Extensive experience in negotiating and managing Managed Care Contracts required. Knowledge of Illinois Medicaid Managed Care program and experience with other states' Medicaid programs strongly preferred.

Other Requirements: Flexibility in schedule required; occasional travel as needed.

Knowledge, Skills, and Abilities:

In-depth knowledge of billing, coding guidelines, compliance, and regulations.

Proficient in electronic health records (EHR) and practice management systems. EPIC (preferred)

Strong understanding of orthopedic terminology and procedures.

Exceptional organizational, multi-tasking, and analytical skills.

Excellent communication, leadership, and negotiation abilities.

Strong data analysis background; proficiency in Excel, pivot tables, and other reporting tools to identify trends and improve revenue cycle performance.

Ability to review, interpret, and ensure the accuracy of medical documentation.

Ability to maintain high productivity and accuracy in a fast-paced environment.

Mental/Physical Requirements:

Primarily sedentary role; approximately 90% computer-based work.

Ability to remain focused in a high productivity, fast-paced environment.

Benefits

Why Join Genesis Orthopedics & Sports Medicine?

At Genesis Orthopedics & Sports Medicine, we believe high-quality orthopedic care should be accessible to all—not just those who can afford it. After 17 years of conventional practice, we took a step back, challenged the status quo, and reimagined healthcare delivery. Over four years, through hundreds of hours of research, global case studies, and bold innovation, we developed a new model that maintains our reputation for exceptional care while making our services more ethical and affordable.