Senior Manager/Director of Revenue Operations

Locations: Washington, DC; New York, NY; Austin, TX.

Description

Release Recovery is bringing its insurance billing operations fully in-house and seeking a Senior Manager/Director of Revenue Operations to lead that transition. This is an opportunity to build the systems, workflows, and team that support our next stage of growth.

This role combines leadership with hands-on execution across the revenue cycle, including eligibility verification, utilization review, claims management, payer relations, reimbursement, denial resolution, and billing compliance. The ideal candidate has experience building revenue cycle operations, improving performance, and working closely with clinical and operational teams.

Responsibilities

• Revenue Cycle Management
• Manage insurance billing operations from eligibility verification through final reimbursement.
• Build and improve revenue cycle workflows across outpatient, partial hospitalization (PHP), intensive outpatient (IOP), and case management services.
• Develop the team and infrastructure needed to support in-house operations.
• Maintain internal controls that support accurate, compliant billing.
• Monitor and improve clean claim rates, days in accounts receivable, authorization approval rates, denial trends, net collection percentages, and reimbursement variances.
• Identify process inefficiencies and implement automation and technology solutions.
• Claims and Billing Operations
• Oversee claim creation, coding accuracy, submission, payment posting, and reconciliation.
• Ensure billing follows applicable CPT, HCPCS, and ICD-10 coding standards for behavioral health services.
• Validate charge capture and supporting documentation before claim submission.
• Manage electronic billing systems, clearinghouses, and electronic health record integrations.
• Maintain current payer billing rules and submission requirements.
• Denials, Appeals, and Accounts Receivable
• Develop denial prevention and appeal strategies.
• Oversee clinical and administrative appeals in partnership with clinical leadership.
• Analyze denial trends and implement corrective actions.
• Manage accounts receivable follow-up to ensure timely claim resolution.
• Lead reimbursement renegotiation efforts when appropriate.
• Partner with legal, compliance, and clinical leadership on complex escalations and payer disputes.
• Payer Relations and Contracting
• Analyze reimbursement rates, fee schedules, and payer contract performance.
• Support payer negotiations through reimbursement analysis, utilization data, and financial modeling.
• Monitor payer policy changes and communicate their operational impact.
• Reporting and Analytics
• Develop revenue cycle dashboards and operational reports.
• Provide leadership with insights on payer mix, reimbursement trends, collections, and operational performance.
• Forecast revenue using census, payer mix, and authorization utilization.
• Identify and address the causes of revenue leakage and reimbursement delays.
• Billing Compliance and Audit Readiness
• Ensure revenue cycle practices comply with payer contracts and applicable state and federal requirements.
• Maintain HIPAA compliance and accurate billing and authorization records.
• Lead internal billing audits and support external payer audits.
• Partner with clinical and compliance leadership to address documentation and billing concerns.

Requirements

• Proven experience in healthcare revenue cycle management, preferably in behavioral health, substance use treatment, or a related setting.
• Experience building or expanding in-house insurance billing and revenue cycle operations.
• Strong background in insurance billing, claims management, accounts receivable, and denial resolution.
• Ability to develop workflows, establish priorities, and implement solutions in a growing organization.
• Strong understanding of CPT, HCPCS, and ICD-10 coding, payer guidelines, and behavioral health billing requirements.
• Proficiency with EMR/EHR platforms, clearinghouses, and revenue cycle technology. Experience with Kipu, CollabMD, Apero, and QuickBooks is strongly preferred.
• Strong analytical and problem-solving skills, with the ability to translate data into operational improvements.
• Working knowledge of HIPAA, applicable OASAS requirements, and federal healthcare billing requirements.