Revenue Cycle Manager

TriasMDNewport Beach, CA
4d$160,000 - $195,000

About The Position

TriasMD is seeking a Director of Revenue Cycle Management (RCM) to lead and optimize the end-to-end revenue cycle across its growing network of ambulatory surgery centers (ASCs) and affiliated physician practices. This role will serve as the internal owner of revenue cycle performance, responsible for overseeing outsourced RCM vendors, partnering with operations and clinical leadership, and implementing data-driven processes to improve collections performance, reduce denials, and accelerate cash flow. The Director will play a critical role in building a scalable revenue cycle infrastructure for a private equity-backed, multi-site healthcare platform experiencing rapid growth. This role reports to the Chief Financial Officer.

Requirements

  • 8+ years of experience in healthcare revenue cycle management
  • 3+ years in ASC, surgical specialty, or physician practice RCM
  • Experience managing outsourced RCM vendors
  • Deep understanding of: ASC billing payer contracting and reimbursement denial management coding and charge capture workflows

Nice To Haves

  • Experience in private equity-backed healthcare platforms
  • Experience scaling revenue cycle operations across multi-site organizations
  • Strong data and analytics capability (Power BI, Tableau, or similar tools)
  • Strong operational leadership
  • Ability to manage cross-functional teams
  • Deep analytical capability
  • Strong communication skills to work with physicians, operators, and finance leaders
  • The candidate must be able to translate revenue cycle data into actionable operational improvements.

Responsibilities

  • Own the end-to-end revenue cycle, including front-end intake, coding, billing, collections, and denial management.
  • Establish and manage RCM performance dashboards tracking key metrics including: Net collection rate Denial rate AR days AR aging Charge lag First-pass claim acceptance
  • Develop and execute initiatives to improve collections performance and reduce revenue leakage.
  • Serve as the primary internal owner of outsourced RCM vendor performance.
  • Manage billing vendors and ensure compliance with service level agreements (SLAs).
  • Conduct regular vendor performance reviews focused on: denial trends collections performance turnaround times payer follow-up effectiveness
  • Partner with vendors to identify and resolve operational issues impacting claims and reimbursement.
  • Lead denial analytics to identify root causes across the revenue cycle.
  • Distinguish between preventable operational denials and payer-related issues.
  • Implement structured processes to reduce high-volume denial categories, including: authorization failures eligibility verification issues coding errors claim submission errors.
  • Partner closely with operations to strengthen front-end processes, including: insurance eligibility verification prior authorization workflows patient financial counseling point-of-service collections.
  • Implement systems and workflows that reduce first-pass denials and billing errors.
  • Lead targeted initiatives to reduce aged accounts receivable.
  • Oversee recovery strategies for >90-day AR balances.
  • Identify opportunities to recover collectible legacy AR and improve follow-up workflows.
  • Identify and implement improvements in revenue cycle operations, including: automation of eligibility verification clearinghouse claim edits and scrubbing controls automation of authorization tracking improved documentation and coding workflows.
  • Evaluate emerging technology solutions and automation tools to improve efficiency.
  • Serve as the bridge between: Operations Clinical teams Finance RCM vendors
  • Ensure operational workflows support efficient revenue cycle performance and reduce preventable denials.

Benefits

  • Competitive base salary plus performance-based bonus aligned with revenue cycle performance improvements.
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