Director of Revenue Cycle Management
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Job Description
Director of Revenue Cycle Management at Sleep Doctor, architecting the RCM infrastructure from scratch. Leading automation and optimizing billing operations.
Responsibilities:
- Lead the end-to-end design and implementation of Sleep Doctor’s RCM infrastructure—spanning eligibility verification, prior authorization, claims submission (clinical and DME), denial management, and patient collections.
- Architect the “to-be” state: a modern, API-driven, largely automated revenue cycle built for both commercial and government payors nationwide.
- Partner with engineering and vendor partners to integrate clearinghouses, EHR/practice management systems, and payer APIs into a unified, compliant billing platform.
- Define the “Clean Claim” baseline for both clinical services and DME—establishing data validation rules, documentation requirements, and submission standards.
- Ensure seamless parallel operation of cash-pay and insurance flows without introducing friction to the patient journey.
- Drive aggressive automation across the revenue cycle using AI/ML tools—targeting prior auth packaging, clinical documentation assembly, claims scrubbing, denial prediction, and appeals generation.
- Design patient-facing billing experiences that deliver radical transparency: real-time eligibility, upfront cost estimates, and frictionless balance resolution.
- Serve as the internal RCM subject matter expert—the go-to voice on payor policy, reimbursement trends, coding requirements, and regulatory changes across clinical and DME billing.
- Collaborate cross-functionally with Clinical, Product, Finance, Engineering and Operations to ensure the revenue cycle serves both business goals and patient outcomes.
Requirements:
- Deep RCM Expertise: 8+ years in Revenue Cycle Management in healthcare, with hands-on experience across the full billing lifecycle—eligibility, prior auth, claims, denials, appeals, and patient collections.
- Clinical & DME Billing Experience: You’ve managed RCM for both clinical services and durable medical equipment.
- Government & Commercial Payor Knowledge: You understand the nuances of billing across Medicare, Medicaid, and major commercial plans nationwide—including payor-specific rules, fee schedules, and compliance requirements.
- Automation-First Mindset: You’re not here to manage a status quo process—you want to eliminate manual work through smart system design, AI tooling, and workflow automation.
- Tech-Forward Approach: Comfortable talking APIs with engineers and system architecture with stakeholders.
- Builder Mentality: You’ve built RCM functions or capabilities from scratch—not just inherited and managed them.
- Player-Coach Orientation: You’re energized by doing the work yourself in the early stages and equally energized by the idea of building and leading a team as the business scales.
- Patient-First Philosophy: You believe the best RCM is nearly invisible to the patient—frictionless, transparent, and built around their experience, not just operational efficiency.
- Cross-Functional Fluency: You understand that most billing problems don’t start in billing.
Benefits:
- The Company currently provides medical, vision, and dental insurance and 100% of the employee medical, vision, & dental premiums covered by the Company.
- There is an option to participate in both a medical FSA and dependent care FSA.
- We offer a 401(k) plan, with fully matching contributions up to 3% of salary and 50% matching from 3% to 5% of salary.
- There is a company paid life-insurance policy, and the option to participate in a voluntary pet-insurance policy.
- You will be eligible for Paid Time Off in accordance with the company’s policies.
- Our Seattle-based employees will receive commuter benefits.
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