Centerstone is among the nation’s leading nonprofit behavioral health systems with thousands of employees dedicated to delivering care that changes people’s lives. A dynamic, well-established organization, we offer rewarding opportunities to serve all ages in a variety of settings. Come talk to us about joining the Centerstone team!
JOB DESCRIPTION:
SUMMARY OF POSITION
The Director, Revenue Cycle (FQHC) is responsible for the strategic leadership, oversight, and optimization of revenue cycle operations across the organization's Federally Qualified Health Center (FQHC) services. This position serves as the organization's subject matter expert on FQHC reimbursement methodologies, regulatory requirements, payer relationships, and revenue integrity initiatives. The Director ensures compliance with HRSA, Medicare, Medicaid, and other applicable regulations while maximizing reimbursement, minimizing denials, and improving overall financial performance.
This role partners closely with operational, clinical, compliance, finance, and executive leadership to develop and implement revenue cycle strategies that support organizational growth, operational excellence, and financial sustainability across multiple states.
Essential Duties & Responsibilities
Provide strategic leadership and oversight for all revenue cycle functions, including patient registration, charge capture, coding, billing, collections, denials management, appeals, reimbursement, and accounts receivable.
Serve as the organization's subject matter expert on FQHC reimbursement methodologies, including Medicare and Medicaid Prospective Payment Systems (PPS), encounter billing, and wrap payment processes.
Monitor federal and state regulatory changes affecting FQHC reimbursement and proactively implement operational and billing process improvements.
Develop and execute revenue cycle strategies that improve cash flow, reduce denials, increase clean claim rates, and optimize reimbursement.
Lead the evaluation, development, and implementation of revenue cycle policies, procedures, and best practices.
Oversee day-to-day activities of internal revenue cycle operations and external revenue cycle vendors to ensure performance expectations are achieved.
Analyze key revenue cycle performance metrics, including days in accounts receivable, denial rates, collection rates, payer trends, and reimbursement performance.
Collaborate with clinical, operational, compliance, and finance leaders to ensure accurate documentation, coding, charge capture, and billing practices.
Maintain a comprehensive understanding of Medicare, Medicaid, commercial payer, and managed care reimbursement methodologies impacting FQHC operations.
Manage relationships with governmental and commercial payers to resolve reimbursement issues, negotiate operational improvements, and maximize revenue opportunities.
Lead denial prevention and appeals strategies to reduce revenue leakage and improve organizational financial performance.
Oversee fee schedule maintenance and ensure appropriate reimbursement methodologies are applied across all services.
Support organizational growth initiatives, including new clinic locations, service line expansions, acquisitions, and revenue cycle integrations.
Partner with finance leadership on cash reconciliation, forecasting, revenue integrity initiatives, month-end reporting, and financial analysis.
Familiarity with 340B program operations, compliance requirements, pharmacy billing, and revenue optimization strategies is strongly preferred.
Knowledge, Skills & Abilities
Extensive knowledge of FQHC revenue cycle operations and reimbursement methodologies.
Strong understanding of HRSA compliance requirements and FQHC operational regulations.
Expertise in Medicare, Medicaid, managed care, PPS reimbursement, encounter billing, and wrap payment processes.
Knowledge of revenue cycle best practices, denial management, reimbursement optimization, and revenue integrity principles.
Familiarity with…