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GeneDx · 21 hours ago

Senior Director, RCM Operations

Gaithersburg, MD

Full-time

Onsite

Director/Executive

$200K/yr - $220K/yr

10+ years exp

GeneDx delivers personalized and actionable health insights to inform diagnosis and improve drug discovery. The Senior Director, RCM Operations is responsible for leading and optimizing all aspects of revenue cycle operations, ensuring compliance, driving operational efficiency, and partnering with executive leadership to achieve financial performance goals.

AnalyticsArtificial Intelligence (AI)Health CareHealth DiagnosticsMachine LearningMedicalPredictive Analytics

H1B Sponsor Likely

Responsibilities

Strategic Leadership

Develop and execute long-term strategies for revenue cycle optimization

Collaborate with VP Billing and Reimbursement to align operational goals with organizational objectives and financial targets

Identify potential risks to revenue based on payer policies and requirements

Operational Oversight

Direct daily operations for entire revenue cycle from prior authorization, claim submission through claim follow-up, appeals, payment posting and correspondence

Prioritize collection and appeals efforts to support revenue collections

Identify risks based on payer denials and collaborate with internal stakeholders to remove roadblocks

Prepare metrics and data analysis of successes and projects for the RCM team

Ensure timely and accurate posting of payments and routing of payer communications

Compliance & Risk Management

Maintain adherence to HIPAA, payer guidelines, and audit requirements

Implement and monitor SOPs for compliance across all workflows

Create workflows to ensure efficient collections and accounts receivable operations

Team Leadership

Recruit, mentor, and develop high-performing teams

Foster a culture of accountability, innovation, and continuous improvement

Contribute to overall employee success by evaluating performance on a regular basis and provide effective feedback for growth and improvement

Analytics & Reporting

Analyze payment and denial trends to identify improvement opportunities

Provide actionable insights and reporting to senior leadership

Technology & Process Improvement

Drive automation and system enhancements to improve efficiency

Champion change management and adoption of new tools and processes

Qualification

Revenue cycle managementHealthcare billing knowledgeRCM technology platformsOperational efficiencyRegulatory complianceData analysisChange managementTeam leadership

Required

Bachelor's degree in healthcare administration, business, finance, or related field (Master's preferred)

Minimum 10 years of progressive experience in revenue cycle management, with at least 5 years in a senior leadership role

Deep knowledge of healthcare billing, payer remittance, and regulatory compliance

Proven track record of leading large teams and driving operational improvements

Experience with RCM technology platforms and automation tools

Benefits

Paid Time Off (PTO)

Health, Dental, Vision and Life insurance

401k Retirement Savings Plan

Employee Discounts

Voluntary benefits

Company

GeneDx

Glassdoor2.5

GeneDx uses artificial intelligence and machine learning to analyze patient data to provide insights to transform the practice of medicine.

Founded in 2017

Stamford, Connecticut, USA

1001-5000 employees

https://www.genedx.com

H1B Sponsorship

GeneDx has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

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Trends of Total Sponsorships

2024 (1)