Director Revenue Cycle at Damian Family Care Centers Inc – Jamaica, New York

Overview:

The Director of Revenue Cycle Management (RCM) is responsible for the strategic oversight, optimization, and integrity of all revenue cycle operations across Damian Family Care Centers (DFCC). This role ensures efficient financial performance through effective billing, coding, collections, credentialing, and compliance practices in alignment with FQHC regulations, New York State Medicaid requirements, and organizational goals.

Reporting directly to the Chief Financial Officer (CFO), the Director serves as a key partner to executive leadership, collaborating with the CEO and Financial Controller to drive revenue performance, mitigate risk, and ensure regulatory compliance across all health center operations.

Essential Job Duties

Revenue Cycle Operations & Oversight

· Direct and oversee all revenue cycle functions including billing, coding, collections, credentialing, and reimbursement processes.

· Manage end-to-end revenue flow, ensuring accuracy, timeliness, and compliance with federal, state, and payer-specific regulations.

· Oversee claims batch submissions through eMedNY and third-party clearinghouses; monitor rejection and denial trends and implement corrective actions.

· Perform weekly bank reconciliations and EMR reconciliation processes to ensure alignment between financial and clinical systems.

· Maintain and monitor key revenue cycle metrics, identifying trends and implementing performance improvement initiatives.

Leadership & Staff Management

· Supervise in-house Billing/Coding staff; provide coaching, training, and performance management.

· Oversee and manage the relationship with third-party billing vendors, including Phycare Solutions, ensuring service level expectations are met.

· Develop and deliver ongoing training for staff on billing regulations, EMR updates, and payer requirements.

Compliance, Reporting & Regulatory Requirements

· Ensure compliance with all applicable FQHC, HRSA, Medicaid, Medicare, and commercial payer regulations.

· Lead preparation and coordination of financial and regulatory reporting, including:

o KPMG and other external audits

o MCVR annual report submissions

o Revenue Cycle components of the annual UBS report

· Maintain and oversee CAP, PCMH, and incentive program tracking and reporting.

· Ensure accurate provider and site enrollment in New York State Department of Health systems for Medicaid linkage billing.

Credentialing & Payer Relations

· Collaborate closely with credentialing to ensure timely provider enrollment and re-credentialing.

· Serve as liaison with insurance payer representatives to resolve credentialing issues, denial trends, and reimbursement challenges.

· Oversee restricted recipient reassignment processes through New York State systems.

Training & Front-End Revenue Integrity

· Oversee onboarding and training of front desk staff on eligibility verification systems, payer portals, and accurate patient registration processes.

· Ensure proper setup of patient demographics and insurance information within the EMR to support clean claims submission.

· Orient new providers on billing workflows, coding practices, and credentialing processes.

· Maintain access and credentialing for staff across all payer and eligibility systems.

Vendor & External Relations

· Act as liaison with external partners including laboratories (e.g., LabCorp) to resolve patient billing issues and manage organizational accounts.

· Collaborate with IT and EMR vendors to ensure system optimization and alignment with revenue cycle workflows

Non-Essential Job Duties

· Participate in organizational committees, strategic planning sessions, and special projects as assigned.

· Support implementation of new service lines, sites, or programs from a revenue cycle perspective.

· Assist with grant-related financial reporting as needed.

· Perform other duties as assigned to support departmental and organizational goals.

• Bachelor’s degree in Healthcare Administration, Finance, Business Administration, or related field required; Master’s degree preferred.
• Minimum of 5–7 years of progressive experience in revenue cycle management, preferably within an FQHC or community health setting.
• Minimum of 3 years of leadership or supervisory experience.
• Strong knowledge of Medicaid (including eMedNY), Medicare, and managed care billing practices in New York State.
• In-depth understanding of revenue cycle operations including billing, coding, credentialing, and collections.
• Experience with EMR systems and revenue cycle management platforms.
• Strong analytical skills with the ability to interpret financial and operational data.
• Knowledge of regulatory requirements including HRSA, PCMH, and value-based care programs.
• Excellent communication, leadership, and organizational skills.
• Ability to manage multiple priorities in a fast-paced healthcare environment.

Reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential function

· Ability to lift, carry, push, and pull objects weighing 25–50 pounds.

· Primarily office-based role within a healthcare/clinical setting.

· May require occasional travel between DFCC sites.

· Prolonged periods of sitting, working at a computer, and reviewing detailed financial and operational data.

· May require extended hours during audits, reporting cycles, or system implementations.

· Frequent interaction with staff, leadership, external vendors, and regulatory agencies.