Claim Configuration Analyst Jobs in Florida (NOW HIRING)

The Director of Revenue Cycle owns the end-to-end billing and collections function for a Central Florida healthcare services organization operating across multiple Orlando-area locations. The role manages the department across patient access, coding, billing, AR follow-up, and cash posting, and is the top revenue cycle seat in the organization. It reports to the CFO (with a dotted line to the COO on operational issues at the practice level).

This is a hands-on leadership role, not a pure oversight role. The company needs an operator who can build the playbook (workflows, KPIs, payor escalation paths, denial work queues) while also running the day-to-day. The right candidate has 7+ years of healthcare revenue cycle experience across the full cycle, has managed a billing team at a multi-site provider, has driven measurable improvement in days in AR and net collection rate, and understands how to build a revenue cycle function that scales with the business through the $150M revenue threshold.

Core Responsibilities

Full-Cycle Revenue Cycle Operations

• Own the full revenue cycle end-to-end: patient access and pre-authorization, charge capture and coding oversight, claims submission, payor follow-up, denial management, cash posting, and patient collections.

• Drive net collection rate to 96% or higher across the payor portfolio and maintain days in Insurance AR (>0) below 45 days, with a target glide path to 40 days as the organization scales.

• Manage clean claim submission rate above 95% on first pass; own the rework process for the 5% that come back and the root cause analysis that keeps it from happening twice.

• Establish and run weekly AR aging review with attention on the 60+ and 90+ buckets by payor; escalate aged claims through documented payor escalation paths.

• Lead denial management with categorical denial tracking (registration, authorization, coding, medical necessity, timely filing); set weekly working denial targets per FTE and report root-cause trends to the CFO monthly.

Payor & Collections Management

• Own the payor relationship from a billing operations standpoint: provider enrollment, credentialing coordination with HR/Operations, contract performance monitoring against fee schedules, and underpayment recovery.

• Manage the collections allowances methodology in coordination with the Controller: reconcile billed gross charges to contractual adjustments and bad debt write-offs, validate reserve adequacy, and explain monthly variances against historical collection patterns.

• Run the patient collections function including statement cycles, payment plan administration, financial counseling coordination, and management of bad debt placement with outside agencies.

• Monitor payor mix by location and service line; flag shifts that affect net revenue and partner with the Controller and CFO on reforecasting implications.

Team Leadership & Development

• Lead, develop, and coach the internal team, coding oversight, AR follow-up, and cash posting. Set individual productivity standards (claims worked per day, denial resolution targets, AR touches per FTE) and hold the team to them.

• Build the team's bench. As the company scales toward $150M, the function will need supervisor-level structure that does not exist today.

• Recruit, hire, and retain. Healthcare RCM talent in Central FL is a tight market, and the role owns the talent strategy inside the function including retention compensation conversations with HR.

• Coordinate with practice managers and clinic leadership at each operating location on front-end revenue cycle workflows (registration accuracy, insurance verification, point-of-service collections).

Systems, Reporting & Process Improvement

• Own the practice management and billing system from a revenue cycle operations standpoint. Drive system optimization, work queue configuration, edits and scrubber rules, and integration points with the GL.

• Build and maintain the revenue cycle KPI dashboard: net collection rate, gross collection rate, days in AR (>0 and >90), denial rate by category, clean claim rate, point-of-service collection rate, cost to collect.

• Produce monthly revenue cycle reporting to the CFO and the leadership team with the discipline of a financial report: actuals against targets, variance commentary, root-cause analysis on misses, and the operational actions tied to each.

• Lead process improvement initiatives across the cycle. As the org grows from $90M to $150M, every workflow that depends on tribal knowledge becomes a scaling failure point. Documentation, work instructions, and SOPs are part of the job.

Compliance & Audit Support

• Maintain compliance with payor contractual requirements, HIPAA, state and federal billing regulations, and any program-specific requirements (Medicare, Medicaid managed care plans, commercial payors) applicable to the organization's service mix.

• Support the annual financial statement audit on revenue cycle related testing: claims data extracts, AR aging reconciliations, contractual allowance support, and bad debt reserve validation.

• Coordinate with internal compliance and external coding audits; remediate findings on documented timelines.

Qualifications

Required Education & Experience

• Bachelor's degree in Healthcare Administration, Business, Finance, or related field. Equivalent combination of relevant certifications and progressive RCM experience considered.

• 7+ years of progressive healthcare revenue cycle experience covering the full cycle: patient access through cash posting, with hands-on time in denial management and AR follow-up.

• 3+ years in a revenue cycle leadership role (Manager, Senior Manager, or Director-equivalent) at a healthcare provider organization. Multi-site provider experience strongly preferred.

• Demonstrated track record of improving days in AR and net collection rate at a previous organization. Candidates should be able to quantify what they inherited, what they delivered, and over what timeframe.

• Experience building or rebuilding revenue cycle processes at a growing organization. Candidates whose experience is limited to maintaining a mature, established RCM operation are not the right fit.

• Direct people leadership of teams of 5 or more across billing, AR, and collections functions.

Required Skills & Competencies

• Working knowledge of the full revenue cycle: front-end (registration, insurance verification, pre-authorization), mid-cycle (charge capture, coding oversight, claims edits), and back-end (claims submission, AR follow-up, denial management, cash posting, patient collections).

• Generalist healthcare RCM background across payor mix: Motor Vehicle Accident, Workers Compensation, Commercial PPO/HMO, and self-pay. Comfort working multiple payor flavors without needing to retrain.

• Strong knowledge of healthcare billing and coding (CPT, ICD-10, HCPCS, modifier usage). Active coding credential (CPC, CCS, or equivalent) is a plus but not required if the candidate has equivalent operational experience.

• Hands-on competency in a practice management or hospital billing system (Athena, NextGen, eClinicalWorks, Epic Resolute, Cerner, AdvancedMD, Greenway, or comparable). Specific platform background is not a filter; ability to learn and optimize a system is.

• Advanced Excel for AR analysis, denial tracking, and KPI reporting. SQL or report-writing experience a plus.

• Clear written and verbal communication. Must brief the CFO and the leadership team in financial language, brief practice managers in operational language, and brief team members in actionable terms.

Preferred

• Direct experience taking a healthcare services organization through the $100M revenue threshold or comparable growth-stage build.

• Certified Revenue Cycle Representative (CRCR), Certified Revenue Cycle Professional (CRCP), or Certified Healthcare Financial Professional (CHFP).

• Prior experience at a PE-backed or sponsor-owned healthcare services platform.

• Multi-specialty or multi-service-line provider experience (combination of professional billing and facility billing if applicable to the organization's service mix).

• Experience supporting M&A integration of acquired practices into a consolidated revenue cycle function.

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