Position Overview
Mackenzie Stuart is currently partnered with a PE-backed Optometric group that is searching for a Director of RCM. The Director of Revenue Cycle is responsible for leading, optimizing, and scaling all revenue cycle functions across a high‑growth, private‑equity‑backed optometry/optical platform. This leader oversees billing, coding, reimbursement, payer relations, denials management, and revenue integrity to ensure accurate, efficient, and compliant financial operations across a multi‑state footprint.
The ideal candidate has deep knowledge of both optometry billing and optical retail revenue models (vision plans, medical billing, optical POS, managed care), along with experience driving performance improvement in a PE‑backed or rapidly scaling MSO/PPM environment.
Key Responsibilities
Revenue Cycle Leadership
- Lead end‑to‑end RCM operations, including patient access, charge capture, coding, claims, denials, AR, payment posting, and collections.
- Develop and implement standardized revenue cycle processes across all clinic and optical retail locations.
- Build and manage RCM KPIs and dashboards; track performance and provide actionable insights to executive leadership.
- Partner with operations and clinic leaders to ensure all workflows support accurate documentation, coding, and charge capture.
Financial & Operational Optimization
- Reduce AR days, improve clean‑claim rates, and enhance point‑of‑service collections.
- Oversee denials trending and root‑cause analysis; implement strategies to reduce preventable denials.
- Collaborate with IT and vendors to optimize RCM systems, EMR/EHR functionality, and optical POS workflows.
- Support integration efforts for acquisitions, including system onboarding, process alignment, and revenue integrity checks.
Payer Relations & Compliance
- Serve as the primary contact for payer escalations and contract‑related RCM issues.
- Ensure compliance with all federal, state, and payer regulations (HIPAA, CMS guidelines, managed vision policies, etc.).
- Develop training programs for front‑office, clinical, and billing teams to ensure accuracy and compliance in documentation and billing workflows.
Team Leadership
- Lead, mentor, and develop a multi‑disciplinary RCM team.
- Establish clear performance standards and evaluate team productivity and quality metrics.
- Drive a culture of accountability, continuous learning, and operational excellence.
Qualifications
Required
- 7+ years of progressive revenue cycle leadership experience in healthcare.
- Strong understanding of both optometry billing and optical/vision plan reimbursement.
- Experience supporting multi‑site operations (20+ locations preferred).
- Demonstrated success improving RCM KPIs—AR days, denial rates, clean‑claim percentage, POS collections, etc.
- Proficiency with healthcare EMRs, RCM systems, and optical POS platforms.
- Must reside in Eastern or Central Time Zones.
Preferred
- Experience in a PE‑backed, high‑growth MSO/PPM environment.
- Experience with acquisitions, RCM integration, and standardizing processes across multiple sites.
- Bachelor’s degree in Healthcare Administration, Business, Finance, or related field (Master’s preferred).
- CPC or CPB certification is a plus.
Key Competencies
- Analytical and data‑driven decision‑making
- Strong leadership and communication skills
- Deep knowledge of payer rules (medical + vision benefits)
- Process optimization and change‑management expertise
- Ability to work effectively in a fast‑paced, high‑growth, remote environment