Director of Revenue Cycle Management & Credentialing

<p></p><p><br></p><b>About Us:</b><div> <p style="margin-top: 0pt; margin-bottom: 0pt;"><span style="font-size: 11pt; font-family: Arial, sans-serif;">Heartbeat Health is the leading virtual-first cardiovascular care company in the country, providing patients with convenient, high-quality heart care through a combination of telemedicine, diagnostics, and virtual care programs. By leveraging real-time data and AI-powered insights, Heartbeat Health empowers providers and patients with personalized treatment plans, reducing hospitalizations and improving long-term heart health outcomes. Heartbeat Health is redefining how cardiovascular care is delivered in the digital age, led by our medical group of cardiologists, advanced practitioners, nurses, and care coordinators. </span></p> </div><p><br></p><b>About the Role:</b><p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 6pt;"><span style="font-size: 11pt; font-family: Arial, sans-serif;">We are a nationwide virtual cardiology organization seeking a Director of Revenue Cycle Management & Credentialing to lead and continuously improve the revenue cycle and credentialing functions that power our growing multi-state provider network. This role owns end-to-end accountability for the full revenue cycle and oversees provider credentialing and payer enrollment across government and commercial payers. The Director will lead RCM operations across internal teams and external partners, lead the credentialing team, and serve as the owner of RCM and credentialing performance, reporting, and continuous improvement. This is a high-impact role responsible for ensuring strong financial outcomes, payer enrollment integrity, and operational visibility as the organization scales claims volume in a multi-state, multi-payer specialty care environment. The Director reports to the SVP of Clinical Operations.</span></p> <p style="line-height: 1.2; margin-top: 12pt; margin-bottom: 6pt;"><strong><span style="font-size: 13pt; font-family: Arial, sans-serif;">Key Responsibilities</span></strong></p> <p style="line-height: 1.2; margin-top: 8pt; margin-bottom: 4pt;"><strong><em><span style="font-size: 11pt; font-family: Arial, sans-serif;">Revenue Cycle Management</span></em></strong></p> <ul style="margin-top: 0px; margin-bottom: 0px; padding-inline-start: 48px;"> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Own end-to-end accountability for the full revenue cycle, including charge capture, claim submission, denial management, payment posting, AR follow-up, patient billing, and collections.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Manage RCM execution across internal staff and external vendors as appropriate, including SLA oversight, performance management, escalation, and ensuring full visibility into work completed on the organization’s behalf.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Lead continuous improvement of RCM processes and the supporting technology stack, with a focus on financial visibility within clinical workflows and reduction of manual handoffs.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Develop and implement new RCM processes and workflows that improve scalability, reduce manual work, and support consistent execution across internal teams </span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Build and maintain reporting and analytics on denial trends, payer performance, AR aging, reimbursement, provider productivity, and collection rates.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Drive initiatives to reduce denial rates, accelerate cash collection, and improve net collection percentage.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Continuously evaluate the optimal mix of internal and external RCM resources and lead the expansion or restructuring of those resources as the organization scales.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Partner with clinical operations, finance, and technology teams to align RCM priorities with broader organizational goals.</span></p> </li> </ul> <p style="line-height: 1.2; margin-top: 8pt; margin-bottom: 4pt;"><strong><em><span style="font-size: 11pt; font-family: Arial, sans-serif;">Credentialing & Payer Enrollment</span></em></strong></p> <ul style="margin-top: 0px; margin-bottom: 0px; padding-inline-start: 48px;"> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Lead and mentor the credentialing function, including direct management of the Credentialing Specialist(s) and any future team growth.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Serve as the organization’s subject matter expert on provider credentialing, payer enrollment, and the connection between credentialing operations and revenue cycle outcomes.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Ensure timely initial credentialing, re-credentialing, and payer enrollment across government and commercial payers in all states of operation.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Optimize credentialing turnaround time and proactively manage payer enrollment timelines to prevent revenue interruption.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Maintain accurate provider records and ensure data integrity between credentialing systems (CAQH, payer portals, internal databases) and billing systems.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Analyze credentialing- and enrollment-related denial trends and implement corrective actions.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Stay current on payer regulations, telehealth credentialing requirements, and licensure rules across all states where the organization operates.</span></p> </li> </ul> <p style="line-height: 1.2; margin-top: 8pt; margin-bottom: 4pt;"><strong><em><span style="font-size: 11pt; font-family: Arial, sans-serif;">Strategic & Cross-Functional Leadership</span></em></strong></p> <ul style="margin-top: 0px; margin-bottom: 0px; padding-inline-start: 48px;"> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Build the long-term RCM and credentialing roadmap aligned with organizational growth.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Prepare regular reports for the SVP of Clinical Operations and executive leadership on RCM and credentialing performance, risks, and opportunities.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Support audits, compliance reviews, and process improvements across both functions.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Represent RCM and credentialing in cross-functional initiatives, including payer contracting, new market expansion, and new clinical program launches.</span></p> </li> </ul><p><br></p><b>About You:</b><div> <ul style="margin-top: 0px; margin-bottom: 0px; padding-inline-start: 48px;"> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field required; advanced degree preferred.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">7+ years of progressive experience in healthcare revenue cycle management, including leadership experience.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Demonstrated experience leading both RCM operations and provider credentialing/payer enrollment functions.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Strong background in multi-state, multi-payer environments; telehealth or virtual specialty care experience strongly preferred.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Experience managing RCM operations across internal teams and external vendors, including SLA oversight and performance accountability.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Working knowledge of clearinghouses, EMR billing modules, ERA processing, and end-to-end claims workflows.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Familiarity with specialty care billing workflows, including chronic care management and transitional care management, preferred.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Strong knowledge of government payer enrollment requirements (Medicare, Medicaid, VA, Tricare) and commercial payer enrollment.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Proficiency with credentialing platforms and payer portals (e.g., CAQH).</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Excellent analytical skills with the ability to translate RCM and credentialing data into operational insight and executive reporting.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Strong project management skills with the ability to manage multiple workstreams, providers, and payer relationships simultaneously.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">Excellent communication skills and the ability to build relationships across clinical, operational, technology, and executive teams.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif; margin-left: -12pt;"> <p style="line-height: 1.2; margin-top: 0pt; margin-bottom: 4pt;"><span style="font-size: 11pt;">High attention to detail, accuracy, and ability to meet strict deadlines.</span></p> </li> </ul> </div><p><br></p><b>About Our Culture:</b><div> <ul style="margin-top: 0px; margin-bottom: 0px; padding-inline-start: 48px;"> <li style="font-size: 11pt; font-family: Arial, sans-serif;"> <p style="margin-top: 0pt; margin-bottom: 0pt;"><strong><span style="font-size: 11pt;">We are mission-driven: </span></strong><span style="font-size: 11pt;">we're revolutionizing the way cardiovascular care is delivered </span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif;"> <p style="margin-top: 0pt; margin-bottom: 0pt;"><strong><span style="font-size: 11pt;">We are fast-paced & agile: </span></strong><span style="font-size: 11pt;">we move quickly, iterate often, and value experimentation</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif;"> <p style="margin-top: 0pt; margin-bottom: 0pt;"><strong><span style="font-size: 11pt;">We are remote-first: </span></strong><span style="font-size: 11pt;">flexibility, autonomy, and trust are at the core of how we operate</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif;"> <p style="margin-top: 0pt; margin-bottom: 0pt;"><strong><span style="font-size: 11pt;">We care about diversity: </span></strong><span style="font-size: 11pt;">diversity allows us to build an excellent patient experience</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif;"> <p style="margin-top: 0pt; margin-bottom: 0pt;"><strong><span style="font-size: 11pt;">We care about each other: </span></strong><span style="font-size: 11pt;">we are stronger together through a culture of mutual respect and active support.</span></p> </li> <li style="font-size: 11pt; font-family: Arial, sans-serif;"> <p style="margin-top: 0pt; margin-bottom: 0pt;"><strong><span style="font-size: 11pt;">We are an equal opportunity employer: </span></strong><span style="font-size: 11pt;">we do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status</span></p> </li> </ul> </div><p><br></p><p></p>

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