Director, Revenue Cycle Management

MEDvidi

Director of Revenue Cycle Management designing and operationalizing insurance revenue cycle for MEDvidi's behavioral health telehealth services. Leading payer credentialing and billing compliance processes for multi-state expansion.

Posted 5/6/2026contractRemote • California, Florida • 🇺🇸 United StatesLeadWebsite

About the role

Key responsibilities & impact

Build cash flow forecasting models for the insurance ramp, including DSO assumptions by payer, denial rate benchmarks, and receivables aging
Select, configure, and own the practice management and billing platform, including integration with the organization's EHR and CRM
Develop and maintain the denial management taxonomy, root-cause analysis workflow, and resubmission processes by payer
Own payer credentialing and enrollment for all providers across target commercial payers in each state, using a credentialing platform such as Medallion or equivalent
Establish and maintain CAQH profiles for all providers and ensure 90-day attestation cadence is met without lapse
Manage supervising physician co-credentialing in supervision states, coordinating with the CMO to ensure coverage is in place before claims are submitted
Track credentialing status, re-credentialing cycles, and payer contract effective dates in a system of record, distinguishing credentialing from contracting as separate workflows
Ensure accurate and defensible use of behavioral health CPT codes: psychiatric evaluation codes, E/M codes for medication management, and add-on psychotherapy codes per AMA guidelines and payer-specific billing rules
Develop and enforce provider documentation standards supporting submitted codes, including DSM-criterion documentation, validated screening tools, and telehealth-specific encounter requirements
Oversee certified coder pre-submission review of all claims, ensuring E/M level accuracy and appropriate ICD-10-CM diagnosis coding
Monitor OIG Work Plan priorities for behavioral health and telehealth and adjust internal audit protocols accordingly
Conduct state-level payer analysis identifying the top commercial payers by covered lives and align target payer selection with the organization's insurance launch strategy
Lead payer contracting conversations in collaboration with the CMO and General Counsel, tracking negotiated rates, contract terms, and effective dates
Develop and maintain a payer performance dashboard tracking denial rates, DSO, reimbursement rates, and appeals outcomes by payer
Maintain audit-ready credentialing files and claim documentation that can withstand payer, state, or federal review

Requirements

What you’ll need

Minimum seven years of progressive revenue cycle experience in a behavioral health, psychiatric, or substance use disorder practice or health system environment, this is a non-negotiable requirement
Demonstrated experience building or significantly rebuilding a revenue cycle operation from early-stage infrastructure, not solely managing an inherited program
Deep working knowledge of behavioral health CPT coding, including psychiatric evaluation codes, medication management E/M codes, and psychotherapy add-on codes
Hands-on experience with commercial payer credentialing and enrollment in a multi-provider, multi-state environment
Practical familiarity with MHPAEA requirements and the application of parity arguments in payer appeals
Working knowledge of telehealth billing regulations, including place-of-service requirements and interstate licensure considerations for telehealth claims
Experience selecting and implementing practice management, billing, and clearinghouse platforms in a behavioral health setting
Strong proficiency in denial management, root-cause analysis, and appeals processes specific to behavioral health payer denials
Demonstrated ability to develop provider documentation standards that support coding accuracy and audit defensibility
Strong working knowledge of HIPAA Privacy and Security Rule requirements as applied to billing and revenue cycle operations
Would be a plus: Experience in a multi-state telehealth or digital health practice environment
Familiarity with 42 CFR Part 2 and its application to billing and records workflows for substance use disorder treatment
Experience with credentialing platforms such as Medallion, Verifiable, or equivalent
CPC, CCS, or CPMA certification from AAPC or AHIMA
Background in healthcare finance, including US GAAP as applied to revenue recognition and AR management
Experience working in a clinically integrated model alongside a CMO or physician leadership team

Benefits

Comp & perks

U.S.-based with a dedicated, HIPAA-appropriate remote workspace

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

cash flow forecastingdenial managementroot-cause analysisCPT codingE/M codingICD-10-CM codingprovider documentation standardsrevenue cycle managementcredentialingbilling regulations

Soft Skills

leadershipcollaborationcommunicationorganizational skillsanalytical skillsproblem-solvingattention to detailstrategic thinkingproject managementinterpersonal skills

Certifications

CPCCCSCPMA