Director of Federal, MCO Revenue Cycle Management

Volunteers of America Chesapeake & Carolinas

. Manage the entire revenue cycle, including eligibility, authorizations, contracting and credentialing, claims billing, collections, rejections and denials management, fiscal reporting, and reconciliations .

Posted 10/3/2026full-timeRemote • Maryland • United StatesLead💰 $110,000 - $120,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing the revenue cycle, including Medicaid billing, claims processing, and staff supervision. Proficient in ensuring compliance with payer regulations and maintaining accurate financial reporting.

Highest-signal resume keywords

Revenue Cycle ManagementMedicaid Billing ExperienceStaff Supervision and TrainingClaims Processing and ReconciliationFinancial Reporting and Audits

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims BillingEligibility VerificationRejections and Denials ManagementEHR ConfigurationBilling Coding Error ReconciliationFinancial AuditsKPI MatricesReport PreparationWorkflow CoordinationGoal Setting

Soft Skills

Problem-Solving SkillsCultural ResponsivenessExcellent Communication Skills

Tools & Technologies

Microsoft OfficeCredible SoftwarePractice Management SystemsThird-Party Clearinghouses

Certifications & Qualifications

CPCCPBCCS

Industry Keywords

Healthcare AdministrationRevenue CycleMedicaid PaymentsPayer RegulationsAccounts ReceivableBilling ProcessesState/Local Billing Procedures

About the role

Key responsibilities & impact

Manage the entire revenue cycle, including eligibility, authorizations, contracting and credentialing, claims billing, collections, rejections and denials management, fiscal reporting, and reconciliations
Report to the VP Finance
Supervise medical billers, authorization staff, and credentialing staff
Ensure EHR configuration and operation comply with payer regulations
Verify insurance and maintain accurate consumer information in the EHR
Use 270/271 eligibility files at the beginning of the month
Ensure authorizations are current and request supplemental units as needed
Clear pre-billing reports before weekly billing and month/year-end close
Supervise Medicaid billing extraction, posting, review, and transmission
Reconcile billing reports with services performed and claims transmitted
Resolve rejected 837p files and resubmit corrected files
Post payments within the month received and work denials within the month received
Approve write-offs and adjustments and perform hard closes in the EHR
Provide financial reports for revenue recognition, accounts receivable reconciliations, adjustments, and payments by the 10th of each month
Assist with yearly financial audits and payer claims audits
Enforce internal and payer regulations with the Compliance team
Ensure providers meet licensure and credentialing requirements for billing
Monitor accounts receivable, appeals, and claim corrections within federal and MCO deadlines
Communicate with staff to resolve billing issues and denied claims; initiate meetings as needed
Maintain relationships with community resources and agencies
Maintain knowledge of billing processes and state/local billing procedures
Maintain knowledge of VOACC and program policies and procedures
Keep required service-related records with Finance
Attend staff and organizational meetings and perform other assigned duties
Travel to assigned locations and operate office equipment as required

Requirements

What you’ll need

Bachelor's Degree in Healthcare Administration or related field
Minimum five years of experience working with Medicaid payments, private insurance or revenue cycle
Minimum three years of experience managing staff and goal setting/development
Specialized training in Medicaid or healthcare billing procedures and revenue cycle
Ability to create parameters for claim accuracy, rectify trend errors, and provide solutions for timely claim processing
Experience coordinating workflow, supervising, and training new or existing staff and managing change related to payment processing and procedures
Experience with appeals and reconciliation of billing coding errors for reimbursement
Experience managing teams, goal setting, benchmarks, and KPI matrices
Ability to research, prepare, maintain, and review reports and documentation accurately and timely
Strong problem-solving and execution skills
Cultural responsiveness and ability to work with individuals from diverse backgrounds
Excellent written and verbal communication skills
Microsoft Office: Word, PowerPoint, Excel, Outlook
Experience with Credible Software, Practice Management Systems, and third-party clearinghouses
Ability to understand various technology systems and general office resources
Ability to operate a motor vehicle and travel to assigned locations
Preferred: Master's degree
Preferred certification as CPC, CPB, or CCS
Bilingual in any language a plus

Benefits

Comp & perks

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