Director - Clinical Denials, Hospital Billing

Qualifications:

• Proven track record developing new ideas, innovative solutions, and operational frameworks that drive thought leadership in revenue cycle management, at least 14 years of experience.
• Strong problem-solving aptitude, with creativity to explore multiple perspectives and encourage innovative thinking within teams and with clients.
• Strategic thinker balancing long-term vision with immediate operational needs and attention to detail.
• Experience driving systemic change by addressing organizational, technological, and process enablers.
• Advocate for technological advancement and integration of automation, AI, and analytics to enhance clinical denial management and hospital billing accuracy.
• Commercially minded with the proficiency to identify market gaps and convert opportunities into firm and client growth.
• Proven ability to uphold and enforce professional and technical standards, including compliance with regulatory, ethical, and the Company’s code of conduct guidelines.
• Skilled at cultivating a healthy, inclusive work culture that fosters development, engagement, and cross-network collaboration.
• Expertise in enterprise Patient Accounting Systems including Epic (Mandatory) or similar platforms.
• Exceptional communication and stakeholder management skills, capable of influencing at executive levels both within the Company and client organizations.

• Set the strategic direction and vision for coding denials and hospital billing operations within RCMS client engagements, aligning with the Company’s broader operational consulting objectives.
• Lead, mentor, and develop senior managers and high-potential staff, building the next generation of revenue cycle leaders.
• Inspire teams and clients alike, promoting a culture of innovation, accountability, and continuous improvement.
• Manage multiple large-scale engagements simultaneously, ensuring delivery excellence and client satisfaction.

• Serve as a senior trusted advisor to healthcare clients, identifying opportunities for operational transformation and financial performance enhancement.
• Collaborate across company’s network to develop integrated revenue cycle solutions combining consulting, technology, and managed services.
• Drive new business development initiatives by leveraging market insight and strong industry relationships.

• Oversee the design and implementation of clinical denial workflows and hospital billing processes that reduce denials, accelerate cash collections, and improve compliance.
• Champion the use of analytics, automation, and technology to transform revenue cycle operations and deliver measurable client impact.
• Guide teams to apply operational excellence methodologies and quality frameworks to enhance service delivery and mitigate risk.

• Ensure all managed service and consulting activities adhere to applicable regulatory requirements and the Company’s rigorous quality standards.
• Lead the enforcement of operational policies, governance, and controls to safeguard client data and maintain the Company’s reputation.