Head Revenue Cycle Management

About the role

The Head of Revenue Cycle Management provides strategic and operational leadership for all revenue cycle functions across the hospital, overseeing patient access, insurance verification, authorisation, medical coding, billing, claims submission, denial management, accounts receivable, collections and payer relations. The role drives revenue growth, minimises revenue leakage, improves efficiency and ensures compliance with regulatory and payer requirements.

Key responsibilities

• Develop and execute the revenue cycle strategy, set departmental goals, KPIs and benchmarks, and advise executive leadership on trends, risks and opportunities.
• Oversee the full revenue cycle, including patient registration, insurance verification, pre-authorisation, charge capture, coding, billing, claims submission, payment posting, collections and accounts receivable.
• Manage timely claim submission, lead denial management and appeals, monitor payer performance and ensure compliance with payer contracts and billing guidelines.
• Improve collections, monitor AR ageing and bad debt, develop recovery plans and approve write-offs and adjustments.
• Prepare monthly revenue cycle performance reports for the CFO and executive team, covering net collection rate, AR days, denial rate, clean claim rate, revenue leakage and cash collections.
• Build relationships with insurers, TPAs, government payers and regulators, support contract negotiations and resolve payer disputes and audits.
• Ensure compliance with NHRA regulations, Ministry of Health requirements and payer guidelines; lead internal and external audits and implement risk controls.
• Drive digital transformation by leading HIS, EMR, billing and revenue cycle platform implementation and continuous improvement.
• Lead, mentor and develop the Revenue Cycle, Billing, Coding, Insurance and Collections teams, including performance management, succession planning and training.
• Collaborate with Clinical Operations, Medical Staff, Finance, Patient Access, Health Information Management and Case Management, and support budgeting, forecasting and new service launches.

Required profile

• Bachelor's degree in Finance, Accounting, Healthcare Administration, Business Administration, Health Information Management or a related field; MBA, MHA or similar strongly preferred.
• Professional certifications such as CRCR, CPB, CPC or HFMA Revenue Cycle certification preferred.
• Minimum 10-15 years of progressive experience in revenue cycle, healthcare finance, medical billing, insurance operations or reimbursement in an acute care hospital, rehabilitation facility or large healthcare organisation.
• Minimum 5 years of senior leadership experience managing multi-disciplinary revenue cycle functions.
• Proven track record of improving revenue performance, reducing denials and strengthening collections.

Required skills

• Revenue cycle operations, medical coding and charge capture
• Insurance claims management, denial prevention and appeals
• Accounts receivable and revenue integrity programmes
• Payer contract management and healthcare financial analytics and KPI reporting