Director of Revenue Cycle

Job Title/Position:

Director

Revenue Cycle

Location:

Nashville, TN preferred or in market (remote with light travel)

Reports To:

Vice President of Finance

About Luminary Hospice:

At Luminary Hospice, we are a mission-driven organization that empowers our team members to shape our culture in order to allow them to provide the highest quality support to patients and families throughout their entire end-of-life journey.

Our mission is to deliver personalized care that radiates compassion and preserves dignity for all that we are honored to serve on their end-of-life journey. We are centered on caring for the whole person – with expert medical care, pain management as well as emotional and spiritual support along with resources, information, and emotional support for families and caregivers.

About the role:

Luminary Hospice is seeking a Director of Revenue Cycle to own the entire revenue cycle for our growing, multi-state, multi-site hospice organization. That covers everything from eligibility verification through final account resolution. This leader is the single accountable executive for how we get paid: accurately, compliantly, and on time.

The role manages our third-party RCM billing vendor, partners with local agencies to drive best practices, and builds a revenue cycle operation that scales as we add locations, states, and payers.

This is a hands-on role. The ideal candidate knows hospice reimbursement in detail, including NOEs, benefit periods, CTI and face-to-face requirements, levels of care, SIA, RTPs, ADRs, and room and board. They should be comfortable digging into individual accounts to find root causes.

Job Responsibilities:

Revenue Cycle Ownership

Own the full hospice revenue cycle across all sites and states, along with every revenue cycle KPI: cash, DSO, unbilled days, NOE timeliness, claim holds, denials, aging, and write-offs

• Set revenue cycle strategy, policies, staffing, and goals, and report performance and risks to executive leadership
• Lead front-end functions: eligibility and benefit verification, authorizations, and financial clearance for room and board and Medicaid pending patients
• Own pre-billing audit and revenue integrity across levels of care, SIA, and rate maintenance
• Oversee NOE/NOTR filing, monthly claim submission, RTP correction, timely filing, payer follow-up, denials, and appeals for ADR, TPE, and other medical reviews

Drive timely resolution of claim holds, such as unsigned orders, missing CTIs or face-to-face encounters, NOE issues, and eligibility gaps, so claims go out on schedule every billing cycle

• Oversee payment posting, adjustments, recoupments, credit balances, refunds, and reconciliation of cash to bank deposits, remittances, and the general ledger
• Own Medicare and Medicaid enrollment for all provider numbers, Hospice Cap monitoring and reporting, and revenue cycle readiness for new sites and acquisitions
• Third-Party RCM Vendor Management
• Manage our third-party RCM billing vendor, including scope of work, SLAs, performance scorecards, and regular operating reviews
• Hold the vendor accountable for submission timeliness, follow-up, posting accuracy, backlog, and cash results, and escalate and correct gaps quickly
• Keep independent oversight through account-level audits and validation of vendor-reported metrics, and advise on contract terms and renewal
• Local Agency Partnership
• Collaborate with local agency leaders to make sure revenue cycle best practices are followed consistently at every location
• Train agency teams on admission paperwork, election statements, CTI and face-to-face timeliness, orders, and documentation requirements
• Hold regular reviews with each agency covering claim holds, unbilled days, NOE timeliness, and denials, with clear owners and follow-up
• Process, Systems, and People
• Standardize workflows, SOPs, and controls across all sites, and build dashboards that turn data into action
• Find system and workflow gaps in the EMR ([HCHB / WellSky / Axxess / MatrixCare]) and clearinghouse, and evaluate automation and AI opportunities responsibly
• Build and develop the revenue cycle team through clear expectations, coaching, and performance management

Work with Finance on month-end close, reserves, cash forecasting, and Cap liability, and maintain compliance with the Hospice CoPs, CMS/MAC and state Medicaid rules, HIPAA, and internal policies

Job Qualifications:

Bachelor's degree in healthcare administration, business, finance, or a related field, or equivalent experience

10+ years of healthcare revenue cycle experience, including 5+ years in leadership.

Hospice revenue cycle experience is required.

• Experience leading the full revenue cycle for a multi-site hospice organization, preferably across multiple states
• Expert knowledge of the Medicare Hospice Benefit and hospice billing, from eligibility and NOE through payment, denials, and final resolution
• Experience managing a third-party RCM or billing vendor through SLAs, scorecards, and audits
• Experience working with agency or field leadership to reduce claim holds and improve documentation
• Proven ability to build or turn around revenue cycle operations, with strong analytical skills and a track record of leading teams through change and growth

Preferred Qualifications:

• Master's degree in healthcare administration, business, or finance
• Experience with hospice acquisitions, de novo locations or system conversions
• Experience with multiple MACs, state Medicaid programs, Hospice Cap, and medical review
• Experience with hospice EMRs (HCHB, WellSky, Axxess, MatrixCare) and revenue cycle automation
• Certification such as CHFP, CRCR, CHPCA, or CHPC
• Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• While performing the duties of this job, the employee is frequently required to sit or stand. The employee must occasionally lift and/or move up to 50 pounds.
• Equal Employment Opportunity: Luminary Hospice is an equal opportunity employer and is committed to creating a diverse and inclusive workplace. We do not discriminate against any applicant or employee based on race, color, religion, gender, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, genetic information, or any other characteristic protected by federal, state, or local laws. We are committed to providing a work environment free from discrimination and harassment, where all individuals are treated with respect and dignity. All employment decisions at Luminary Hospice are based on business needs, job requirements, and individual qualifications.