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Director of Revenue Cycle Management – Credentialing
Heartbeat HealthDirector of Revenue Cycle Management leading revenue cycle and credentialing for a virtual cardiology organization. Ensuring strong financial outcomes and operational visibility as the organization scales.
About the role
Key responsibilities & impact- Own end-to-end accountability for the full revenue cycle, including charge capture, claim submission, denial management, payment posting, AR follow-up, patient billing, and collections.
- Manage RCM execution across internal staff and external vendors as appropriate, including SLA oversight, performance management, escalation, and ensuring full visibility into work completed on the organization’s behalf.
- Lead continuous improvement of RCM processes and the supporting technology stack, with a focus on financial visibility within clinical workflows and reduction of manual handoffs.
- Develop and implement new RCM processes and workflows that improve scalability, reduce manual work, and support consistent execution across internal teams.
- Build and maintain reporting and analytics on denial trends, payer performance, AR aging, reimbursement, provider productivity, and collection rates.
- Drive initiatives to reduce denial rates, accelerate cash collection, and improve net collection percentage.
- Continuously evaluate the optimal mix of internal and external RCM resources and lead the expansion or restructuring of those resources as the organization scales.
- Partner with clinical operations, finance, and technology teams to align RCM priorities with broader organizational goals.
- Lead and mentor the credentialing function, including direct management of the Credentialing Specialist(s) and any future team growth.
- Serve as the organization’s subject matter expert on provider credentialing, payer enrollment, and the connection between credentialing operations and revenue cycle outcomes.
- Ensure timely initial credentialing, re-credentialing, and payer enrollment across government and commercial payers in all states of operation.
- Optimize credentialing turnaround time and proactively manage payer enrollment timelines to prevent revenue interruption.
- Maintain accurate provider records and ensure data integrity between credentialing systems (CAQH, payer portals, internal databases) and billing systems.
- Analyze credentialing- and enrollment-related denial trends and implement corrective actions.
- Stay current on payer regulations, telehealth credentialing requirements, and licensure rules across all states where the organization operates.
- Build the long-term RCM and credentialing roadmap aligned with organizational growth.
- Prepare regular reports for the SVP of Clinical Operations and executive leadership on RCM and credentialing performance, risks, and opportunities.
- Support audits, compliance reviews, and process improvements across both functions.
- Represent RCM and credentialing in cross-functional initiatives, including payer contracting, new market expansion, and new clinical program launches.
Requirements
What you’ll need- Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field required; advanced degree preferred.
- 7+ years of progressive experience in healthcare revenue cycle management, including leadership experience.
- Demonstrated experience leading both RCM operations and provider credentialing/payer enrollment functions.
- Strong background in multi-state, multi-payer environments; telehealth or virtual specialty care experience strongly preferred.
- Experience managing RCM operations across internal teams and external vendors, including SLA oversight and performance accountability.
- Working knowledge of clearinghouses, EMR billing modules, ERA processing, and end-to-end claims workflows.
- Familiarity with specialty care billing workflows, including chronic care management and transitional care management, preferred.
- Strong knowledge of government payer enrollment requirements (Medicare, Medicaid, VA, Tricare) and commercial payer enrollment.
- Proficiency with credentialing platforms and payer portals (e.g., CAQH).
- Excellent analytical skills with the ability to translate RCM and credentialing data into operational insight and executive reporting.
- Strong project management skills with the ability to manage multiple workstreams, providers, and payer relationships simultaneously.
- Excellent communication skills and the ability to build relationships across clinical, operational, technology, and executive teams.
- High attention to detail, accuracy, and ability to meet strict deadlines.
Benefits
Comp & perks- We are mission-driven: we're revolutionizing the way cardiovascular care is delivered
- We are fast-paced & agile: we move quickly, iterate often, and value experimentation
- We are remote-first: flexibility, autonomy, and trust are at the core of how we operate
- We care about diversity: diversity allows us to build an excellent patient experience
- We care about each other: we are stronger together through a culture of mutual respect and active support.
- We are an equal opportunity employer: we do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
revenue cycle managementcharge captureclaim submissiondenial managementpayment postingAR follow-uppatient billingcollectionscredentialingpayer enrollment
Soft Skills
leadershipanalytical skillsproject managementcommunication skillsattention to detailrelationship buildingperformance managementcontinuous improvementmentoringorganizational skills