Director of Revenue Optimization & Billing

Location: Remote (U.S.-based)
Reports to: SVP, Revenue Cycle Management
Department: Revenue Cycle Management (RCM)

Position Summary
The Director of Revenue Optimization & Billing is a senior RCM leader responsible for enterprise billing performance, charge capture optimization, clean claim execution, and revenue yield across a multi-site orthopedic organization, including clinics and ambulatory surgery centers (ASCs). This role ensures services are billed accurately, timely, compliantly, and at the highest appropriate reimbursement level.

Key Responsibilities

Billing Operations & Clean Claim Performance
• Executive oversight of professional, ASC, and ancillary billing teams
• Accurate and timely charge capture and claim submission
• Ownership of clean claim rate, first-pass yield, and billing timeliness
• Close partnership with coding and clinical teams

Revenue Optimization & Yield Improvement
• Identification of missed or underbilled services
• Standardization of billing practices across sites
• Adoption of new CPT/HCPCS codes and ASC-approved procedures
• Collaboration with revenue integrity and contracting teams

Denials Prevention
• Ownership of pre-A/R denial prevention strategies
• Analysis and mitigation of eligibility, authorization, and billing denials

Leadership & Culture
• Lead and develop remote billing teams
• Establish performance metrics and workflows
• Promote continuous improvement and accountability

Strategy & Scalability
• Use of analytics and dashboards to drive decisions
• Automation and standardization to support growth
• Support RCM centralization and new practice integration
• Ensure billing compliance with payer and regulatory standards

Qualifications

Required
• 10+ years of progressive revenue cycle experience
• Significant billing leadership experience
• Proven success improving clean claims and revenue yield
• Experience managing remote billing teams
• Strong orthopedic and ASC billing knowledge

Preferred
• Multi-site orthopedic or surgical MSO experience
• Experience partnering across RCM disciplines