Director of Revenue Cycle

This strategic role is responsible for overseeing the Trust Fund Eligibility and Revenue Cycle departments, ensuring accurate billing, claims processing, collections, and benefits management. The ideal candidate will lead with a strong sense of service excellence, accountability, and commitment to our mission of enhancing the lives of individuals with intellectual and developmental disabilities.

 

• Provide direct leadership to the Revenue Cycle Manager and Trust Fund Eligibility Manager, ensuring cohesive operations across the full revenue lifecycle.
• Establish and maintain departmental goals, KPIs, and best practices in alignment with
• Caregiver Inc.’s mission and regulatory requirements.
• Oversee timely and accurate billing, claims submission, and reimbursement processes across all services, including Host Home/Family Model, adaptive aides, and ancillary care.
• Ensure accurate maintenance of individual benefits and trust fund accounts through compliance with state and federal eligibility guidelines.
• Partner with IT and operations to continuously improve systems, workflows, and automation of billing and eligibility functions.
• Lead initiatives to reduce denials, optimize reimbursement, and improve revenue cycle efficiency through performance improvement and staff training.
• Regularly monitor department reporting and financial metrics; implement corrective actions as needed to improve outcomes.
• Ensure team compliance with payer requirements (Medicare, Medicaid, Commercial), HIPAA, and applicable federal/state laws.
• Foster a culture of transparency, compassion, and accountability aligned with the organization’s person-centered approach.
• Represent the revenue cycle function in cross-functional leadership meetings and strategic planning sessions.