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About You

You are someone who is passionate about bringing end-to-end Revenue Cycle Central Business Office services together to improve financial performance, operational excellence, the patient financial experience. We need someone who can lead and develop high-performing teams and use data and operational insights to drive results. In the role of Revenue Cycle CBO Director, you will help shape an evolving CBO model and make a meaningful impact on the financial strength and long-term sustainability of rural healthcare.

• Tell us about your experience in End-to-End Revenue Cycle Leadership.
• Are you a team player and a self-motivator?
• What is your experience with conducting business in a way that is credit to a company?
• We are counting on you to manage multiple projects using your problem-solving skills.
• We are looking for someone UNCOMMON. What is uncommon about you?

Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you.

About The Position

• Lead end-to-end revenue cycle performance across Patient Access, Coding/CDI, Revenue Integrity, and PFS within the TRC CBO.
• Identify upstream and downstream drivers of revenue leakage, denials, payment delays, and patient financial friction and drive cross-functional improvement.
• Establish standardized workflows, controls, service levels, escalation pathways, and performance accountability across participating hospitals.
• Serve as the accountable CBO operational leader while developing functional Managers as owners of domain performance and execution.
• Serve as an executive-facing leader, translating complex revenue cycle performance into clear, compelling narratives, insights, and recommendations for Monthly Operating Reviews, Hospital Boards, C-Suite executives, and other internal and external executive stakeholders.

• Apply strong knowledge of CAH reimbursement, including cost-based reimbursement and requirements across inpatient, swing bed, outpatient, emergency, observation, and other in-scope services.
• Anticipate payer, regulatory, reimbursement, and operational changes affecting rural hospitals and translate impacts into effective operational response.

• Provide leadership and oversight for in-scope Patient Access functions, including registration, eligibility and benefits verification, prior authorization, medical necessity, financial clearance, patient estimates, financial counseling, and point-of-service collections.
• Drive front-end accuracy and timely financial clearance to support clean claims, reduce avoidable denials, accelerate cash, and improve the patient financial experience.
• Establish performance standards and root-cause processes for authorization, eligibility, registration accuracy, medical necessity, and point-of-service collection performance.
• Partner with hospital-retained and clinical teams when upstream workflows affect CBO outcomes.

• Lead Coding and CDI across participating CAHs, including inpatient, swing bed, outpatient, emergency, observation, clinic, and professional coding as applicable to scope.
• Ensure timely, accurate, and compliant coding and documentation through effective quality, productivity, audit, education, provider query, and CDI practices.
• Drive coding- and documentation-related DNFB reduction, claim edit resolution, denial prevention, and root-cause improvement in partnership with providers, clinical leadership, Case Management, and hospital-retained HIM.
• Oversee revenue integrity, including charge capture and reconciliation, charging controls, revenue-related edits, and identification and prevention of revenue leakage.
• Partner across Patient Access, Coding/CDI, PFS, clinical departments, Finance, and hospital leadership to identify systemic issues and implement sustainable corrective action.

• Lead billing, insurance follow-up, AR, denials and appeals, underpayments, payment posting, credit balances, refunds, and self-pay operations.
• Drive payer-specific account resolution and escalation strategies to improve cash, reduce aging and avoidable write-offs, and maximize appropriate reimbursement.
• Monitor denial trends, payment variances, payer behavior, and reimbursement changes to identify risk and drive corrective action.
• Translate payer and account-resolution insights into upstream improvements across Patient Access, Coding/CDI, Revenue Integrity, and other hospital stakeholders.

• Establish and manage CBO performance through clear KPIs, productivity, quality, service levels, and financial targets.
• Use data and operational insights to identify performance gaps, quantify impact, prioritize action, and measure improvement.
• Lead operational reviews, clearly communicating performance, risks, corrective actions, and decisions needed while holding leaders accountable for results.
• MORs presentation skills

• Partner with Strategic Operations, Product, and technology teams to identify and implement solutions that improve revenue cycle performance.
• Leverage data, dashboards, and operational intelligence to manage performance, prioritize action, and identify operational risk.
• Champion adoption of technology, automation, and AI-enabled solutions within CBO operations and ensure effective integration into frontline workflows.
• Provide operational feedback and performance insights to support ongoing optimization and value realization.

• Oversee performance of third-party revenue cycle vendors and outsourced services within scope, including clear expectations, service levels, quality standards, escalation processes, and performance reviews.
• Ensure vendor performance is transparent, measurable, and aligned with TRC financial, operational, compliance, and patient experience objectives.
• Identify vendor-related risks, gaps, duplication, or opportunities for consolidation and improvement.
• Coordinate with internal and hospital stakeholders to resolve issues that cross organizational or contractual boundaries.

• Ensure CBO operations adhere to regulatory, payer, billing, coding, organizational, and internal control requirements.
• Partner with Compliance, Finance, and hospital leadership to address risks, corrective actions, and audit readiness.
• Maintain effective operational controls and promptly escalate material compliance, reimbursement, financial, or operational risks.

• Lead, coach, and develop functional Managers, establishing clear accountability, decision rights, and performance expectations.
• Build leadership capability in operational management, problem solving, data-driven decision-making, and associate development.
• Optimize workforce capacity, staffing, productivity, skill mix, and succession to meet operational needs.
• Foster a culture of accountability, collaboration, continuous improvement, service, and operational excellence.

• Serve as the senior operational liaison between the CBO and participating CAHs, building trusted relationships with hospital executives and key stakeholders.
• Communicate revenue cycle performance, risks, opportunities, and action plans clearly and proactively.
• Partner with hospital-retained functions to resolve issues, manage dependencies, and improve end-to-end revenue cycle performance.
• Establish transparent service expectations, responsibilities, escalation pathways, and shared accountability for outcomes.

• End-to-End Revenue Cycle Leadership: Connects front-, middle-, and back-end operations to drive financial, operational, and patient outcomes.
• CAH & Payer Acumen: Understands rural/CAH operations, reimbursement, payer dynamics, denials, and revenue risk.
• Performance & Transformation: Uses data, root-cause analysis, standardization, and change leadership to drive measurable and sustainable improvement.
• People & Partnership Leadership: Builds accountable teams and trusted partnerships across CBO, hospital, clinical, and executive stakeholders.
• Technology & AI-Enabled Optimization: Leverages systems, analytics, automation, and AI to improve performance, workforce effectiveness, and decision-making.

Minimum Requirements:

• Bachelor's degree in healthcare administration, business, finance, or related field required; equivalent directly relevant experience may be considered. CRCR, CHFP, or other relevant revenue cycle certification preferred.
• 7--10+ years of progressive hospital revenue cycle experience, including 5+ years leading multi-functional, centralized, shared-services, or multi-hospital operations preferred.
• Demonstrated end-to-end knowledge across Patient Access, Coding/CDI, Revenue Integrity, and PFS, with experience managing cash, AR, denials, DNFB, coding performance, productivity, quality, and revenue improvement.
• Rural hospital/CAH experience strongly preferred, including working knowledge of CAH cost-based reimbursement and applicable rural reimbursement requirements.
• Experience with payer/denial and underpayment strategy, compliance, operational transformation, workflow standardization, performance improvement initiatives and change leadership.
• Experience managing vendors/service levels and leveraging major EHR platforms (EPIC, Oracle, Meditech etc), analytics, automation, and AI-enabled technologies preferred;
• Experience managing third-party vendors, outsourced revenue cycle services, and service-level performance preferred.
• Required Travel: 25-40% of time
• Time Zone: Must be flexible to work PST zone hours.

About Us

You are uncommon. We are, too. We are looking for people to help us in our mission of working hard at lowering healthcare administrative costs for federal government agencies, payers, and providers. At Signature, our mission is to improve the health of our clients' business and make the lives of the people we work with better. As we continue to experience exponential growth, we are looking for uncommon individuals to enhance our vision. We will continue to accomplish our mission by leading with our values of Passion, Courage, Integrity, and Respect in all interactions, making us a consistent annual Best Places to Work organization. We need uncommon leaders with uncommon qualities to shape our uncommon culture and achieve our uncommon mission.

About the Benefits

When you are a member of Signature Performance, you are a part of a solutions-based organization where the values of passion, integrity, courage, and respect are the driving forces behind all our decision-making. We trust you to do important work and bring the best version of yourself to work every day, so we want to help you achieve a work-life balance while consistently challenging yourself. Signature believes in fully developing each one of our Associates. Our performance-driven philosophy boasts competitive pay and additional position specific incentives, where world-class training and development, resources, and events drive our award-winning culture where everyone thrives.

• Health Insurance
• Fully Paid Life Insurance
• Fully Paid Short- & Long-Term Disability
• Paid Vacation
• Paid Sick Leave
• Paid Holidays
• Professional Development and Tuition Assistance Program
• 401(k) Program with Employer Match

• U.S. Citizenship or naturalized citizenship is required for this position.
• All work on all positions at Signature Performance must be completed in the continental United States, Alaska, or Hawaii.