We are seeking a skilled Revenue Cycle Director(RCM) with experience in
post-submission workflows, denial resolution, and accounts receivable (AR) recovery for a
high-complexity clinical laboratory serving clients in women’s health, toxicology, and genetics.
This role ensures that claims are not only submitted correctly, but also monitored, appealed, and
recovered efficiently — driving revenue integrity and cash flow performance.
Responsibilities:
Review and track submitted claims to ensure timely processing and identify any
delays, denials, or underpayments.
Analyze denial codes, EOBs, and remittance data to determine root causes
and corrective actions.
Initiate and manage appeals, reconsiderations, or corrected claims to
maximize reimbursement.
Collaborate with coding and pre-submission teams to close the feedback loop
and prevent recurring errors.
Maintain accurate documentation and follow-up logs within the billing system or
RCM platform.
Communicate with payers, clearinghouses, and internal departments to resolve
billing discrepancies and verify payment statuses.
Prepare regular AR aging and recovery performance reports for stakeholders
and leadership.
Identify trends in payer behavior and propose process improvements to increase
clean claim rate and reduce DSO (Days Sales Outstanding).
Qualifications:
2+ years of experience in Director level role in medical billing, RCM, or AR follow-up (laboratory or
diagnostic experience strongly preferred).
Deep understanding of EOB interpretation, denial management, and payer
appeals.
Working knowledge of claim adjudication, ERA/EOB reconciliation, and payer
portals.
Familiarity with CPT, ICD-10, and HCPCS coding, as well as payer-specific
reimbursement rules.
Experience using billing software, clearinghouses, and RCM dashboards for
tracking and reporting.
Certification (e.g., CPC, COC, CRCR) preferred but not required.
Personal Skills:
Strong analytical and critical-thinking abilities to assess complex claim issues.
Excellent written and verbal communication, especially for payer
correspondence.
High degree of accuracy and accountability.
Ability to work collaboratively with cross-functional teams including clinical,
operations, and finance.
Persistent and resourceful with a problem-solver mindset.
Self-motivated and organized with a focus on measurable results