A Senior Connection

Oversee end-to-end revenue cycle, manage payer relations, and ensure compliance in healthcare billing. | Requires 8+ years in healthcare revenue cycle, experience with MCPs, and supervisory experience, with an associate degree. | Department: Finance Reports To: Executive Director / COO (or appropriate senior role) Employment Type: Full-Time Location: This is hybrid position. You will be required to have a HIPAA complaint at home office and meet (at minimum quarterly) in Sacramento and surrounding counties. While the position is hybrid, you must be located in Northern California. Those who do not reside in the surrounding areas will not be considered. Position Summary The Director of Revenue Cycle & Accounting Operations is a senior leadership role responsible for end-to-end revenue cycle management, financial controls, payer relations, and accounting oversight for hospital partners and Managed Care–funded services. This role serves as the final authority on billing, denials management, appeals strategy, collections, and reimbursement integrity. The Director holds exclusive or primary system access to QuickBooks and is accountable for accounts payable and receivable, final check approval, and reconciliation. This position oversees revenue cycle staff and collaborates closely with executive leadership to safeguard organizational revenue, ensure compliance with partners, MCP contracts, and regulatory requirements, and continuously improve financial performance. This role requires deep experience with Managed Care Plans (MCPs), complex denials, appeal letters, contract interpretation, and payer negotiations, as well as the ability to lead, mentor, and enforce high standards of accountability. Core Responsibilities Revenue Cycle Leadership & Oversight • Own and oversee the entire revenue cycle, from service delivery through final reimbursement • Serve as the final escalation point for complex denials, underpayments, and payer disputes • Establish and enforce revenue cycle policies, controls, and approval thresholds • Provide strategic guidance to leadership on revenue risk, trends, and payer behavior Managed Care, Denials & Appeals • Lead second-level and final-stage denials management, including high-dollar and systemic issues • Draft, review, and approve formal appeal letters, reconsiderations, and explanations of benefits disputes • Interpret MCP contracts, authorization requirements, and billing rules to ensure maximum compliant reimbursement • Interface directly with MCP representatives to resolve escalated issues and systemic barriers Billing, Compliance & Quality Control • Ensure accurate, timely billing aligned with MCP requirements and regulatory standards • Oversee coding accuracy (ICD-10, HCPCS, modifiers) and documentation sufficiency • Conduct or direct internal audits to ensure compliance, accuracy, and defensibility • Stay current on CalAIM, DHCS, MCP, and billing regulation changes and translate them into operational guidance Accounting & Financial Controls • Maintain primary responsibility for QuickBooks, including system access, configuration, and integrity • Oversee accounts payable and accounts receivable, including final review and approval • Provide final approval on checks, payments, and reconciliations • Reconcile revenue, deposits, and collections across systems (QB, spreadsheets, reports) • Ensure segregation of duties while maintaining appropriate executive-level oversight Staff Supervision & Leadership • Directly supervise and mentor revenue cycle/accounting staff • Set performance expectations, workflows, and accountability standards • Review work products for accuracy, timeliness, and compliance • Build internal capacity through training, documentation, and process improvement Reporting, Analysis & Strategy • Produce and analyze high-level revenue cycle and financial reports for leadership • Monitor AR aging, denial rates, reimbursement trends, and payer performance • Identify revenue leakage risks and implement corrective strategies • Support audits, accreditation reviews, and regulatory reporting requirements • Partner with executive leadership on budgeting, forecasting, and growth planning Required Competencies • Advanced knowledge of Managed Care billing, MCP contracts, and CalAIM-related services • Expert-level experience with denials, appeals, and payer dispute resolution • Strong leadership presence with the ability to make firm, defensible decisions • Exceptional written communication skills, particularly for appeals and formal correspondence • High attention to detail balanced with strategic thinking • Ability to protect sensitive financial and organizational information • Strong judgment, discretion, and accountability Required Qualifications • Minimum 8 years progressive experience in revenue cycle, billing, or healthcare accounting • Minimum 3–5 years in a senior, lead, or supervisory role • Demonstrated experience working directly with Managed Care Plans (MCPs) • Advanced experience with QuickBooks (AP, AR, reconciliations, reporting) • Strong proficiency in Excel; experience using spreadsheets alongside accounting systems • Experience with EMR systems and healthcare billing workflows • Associate’s degree required; Bachelor’s degree preferred (Accounting, Finance, Healthcare Administration, or related field) Preferred Qualifications • Experience in CalAIM, ECM, Community Supports, or similar Medicaid-funded programs • Bilingual English/Spanish • Experience supporting audits, payer reviews, or regulatory reporting What This Role Is Not • This is not an entry-level or client-facing role • This role does not provide direct client services • This position carries final authority and accountability for revenue cycle integrity Job Type: Full-time Pay: $130,000.00 - $160,000.00 per year Benefits: • 401(k) matching • Health insurance • Paid time off Application Question(s): • Do you have experience working with Manage Care Plans (MCP), Medi-cal, Cal-AIM and/or other similar Medicaid-funded programs? Education: • Associate (Required) Experience: • revenue cycle, billing, healthcare accounting: 8 years (Required) • Senior, lead or supervisory role: 3 years (Required) Location: • Sacramento, CA (Required) Work Location: Hybrid remote in Sacramento, CA