Director, Revenue Cycle

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Upward Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2010

🏥 Healthcare

⚕️ Healthcare Insurance

💰 Series C - Upward Health on 2025-01

Healthcare • Healthcare Insurance

Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Their clinical team treats physical, behavioral, and social health needs where patients need help, offering services from management of chronic conditions (e. g. , congestive heart failure) to behavioral health support and connecting patients with social services like medically tailored meals. They serve patients directly and partner with health plans and providers, emphasizing reduced emergency department visits, improved outcomes, and high patient satisfaction. Upward Health operates community-focused care teams including doctors, nurses, and community health workers, and promotes “Healthcare Comes Home” through house calls and transitions-of-care programs.

📋 Description

• Own end-to-end revenue cycle performance across Upward Health operations • Oversee intake, eligibility verification, coding, charge entry, claims submission, accounts receivable follow-up, denial management, payment posting, and collections • Establish and monitor revenue cycle KPIs, including days in AR, denial rate, first-pass resolution rate, and net collection rate • Identify revenue leakage root causes and implement corrective actions • Ensure timely, accurate claims submission and reimbursement across payer types • Serve as the internal subject matter expert for Athenahealth practice management and billing workflows • Configure and optimize Athenahealth system rules, edits, and reporting • Partner with IT and operations on enhancements, automations, and integrations • Troubleshoot system issues and improve platform utilization • Analyze large datasets using advanced Excel capabilities and build leadership dashboards and reporting tools • Translate complex data into operational insights and improvements while ensuring data integrity • Design, document, and standardize revenue cycle SOPs and workflow improvements • Implement AI-enabled tools, evaluate technologies and vendors, and lead automation pilots and deployments • Develop a roadmap for AI integration across revenue cycle functions • Ensure compliance with payer requirements, CMS guidelines, HIPAA, and other regulatory standards • Monitor audits, implement corrective actions, and maintain coding integrity • Lead and develop billing, coding, and accounts receivable teams • Establish performance expectations, coach employees, and foster accountability and continuous improvement • Partner with clinical, operational, finance, and IT leadership

🎯 Requirements

• 7–10+ years of progressive experience in revenue cycle management • Direct, hands-on experience with Athenahealth • Advanced Excel skills, including data modeling and reporting automation • Strong analytical mindset and high attention to detail • Proven track record improving revenue cycle KPIs and operational efficiency • Experience implementing process improvements and workflow automation • Ability to quickly learn and adapt to new systems • Experience leading teams within a healthcare billing or revenue cycle environment • Preferred: experience in value-based care or risk-based contracting environments • Preferred: familiarity with EDI transactions (835/837) and clearinghouse operations • Preferred: experience leveraging AI or automation tools in healthcare operations • Preferred: bachelor’s degree in Healthcare Administration, Finance, or related field; master’s preferred

🏖️ Benefits

• Benefits information is provided via the linked Upward Health Benefits page; specific benefits are not stated in the posting text