Associate Director, Rev Cycle - Prior Authorization in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for an Associate Director, Rev Cycle – Prior Authorization in United States.

This is a senior leadership role within revenue cycle management focused on leading and optimizing prior authorization, pre-certification, and eligibility operations in a high-volume, fast-paced healthcare environment. The position plays a critical role in ensuring timely approvals, clean claims submission, and optimized reimbursement outcomes across multiple payer types. Operating at the intersection of operations, finance, and clinical billing workflows, the role requires strong command of revenue cycle processes and the ability to lead large teams through performance-driven execution. The Associate Director will shape operational strategy, improve efficiency, and ensure compliance while driving continuous improvement across billing and authorization functions. This is a highly impactful role where leadership directly influences financial performance, patient access, and operational excellence in a regulated healthcare setting.

• Lead and oversee prior authorization, pre-certification, and eligibility operations to ensure accurate, timely, and compliant claims submission across all payer types.
• Direct billing operations teams to maximize collections, reduce denials, and ensure efficient management of accounts receivable and reimbursement workflows.
• Develop, maintain, and continuously improve billing policies, procedures, and operational workflows across the revenue cycle process.
• Analyze reimbursement trends, denial patterns, and carrier performance to identify issues and implement corrective strategies.
• Monitor and report on key performance metrics including AR days, cash collections, bad debt, and operational productivity.
• Provide leadership and oversight for staffing, including hiring, onboarding, training, coaching, performance management, and corrective action plans.
• Collaborate cross-functionally with Finance, Sales, Compliance, and operational teams to support reporting, forecasting, and business initiatives.
• Lead process improvement initiatives and identify opportunities for automation, efficiency gains, and workflow optimization.
• Ensure compliance with regulatory requirements, payer guidelines, and internal policies across all billing and authorization activities.
• Serve as a key contributor in strategic planning discussions related to revenue cycle performance and organizational growth.

• Bachelor’s degree in a related field or equivalent professional experience.
• 8+ years of experience in revenue cycle management, with strong focus on prior authorization and billing operations in a high-volume healthcare environment.
• Extensive knowledge of reimbursement processes, billing, coding, payer regulations, and compliance requirements.
• Proven leadership experience managing large, multi-functional teams in a fast-paced operational setting.
• Strong analytical skills with experience using data tools such as Excel and Power BI for reporting and decision-making.
• Deep understanding of accounts receivable management, denial resolution, and revenue cycle optimization strategies.
• Strong communication and interpersonal skills with ability to influence stakeholders at all levels.
• Experience in performance management, coaching, and building high-performing teams.
• Ability to manage multiple priorities, drive operational improvements, and adapt quickly in changing environments.
• Strong problem-solving skills with a focus on continuous improvement and operational excellence.
• Experience working with compliance frameworks and ensuring adherence to healthcare regulations.

• Competitive compensation aligned with senior healthcare operations leadership roles.
• Comprehensive medical, dental, vision, life, and disability insurance coverage.
• 401(k) retirement savings plan.
• Paid parental leave and fertility care benefits.
• Free or discounted access to employee healthcare-related services and testing benefits.
• Commuter and additional employee support programs.
• Generous employee referral program.
• Opportunities for career growth within a rapidly evolving healthcare and diagnostics organization.
• Inclusive and diverse work environment focused on innovation and continuous improvement.