Job Description

About OrthoPediatrics Specialty Bracing:

After over 50years of leading the industry in pediatric orthotic solutions, we've joined forces with OrthoPediatrics to expand their Specialty Bracing Division. Together, we are a company that is dedicated to a very special Cause, that of improving the lives of children with orthopedic related conditions. While we do provide many special products to help kids, we are more than a product company. We are committed to the infinite Idea of improving healthcare for children and improving the lives of their families and friends. We are a unified team of people who believe that to change the world for children we must also invest in one another. Our culture is one that values people before profits, is committed to leadership development, values honesty and transparency, and provides space for people to take risks and try new things. OrthoPediatrics Specialty Bracing is a fulfilling place for personal growth and to make a difference in the lives of others.

Position Description:

The Director of Revenue Cycle is responsible for overseeing all financial aspects of the revenue cycle for OP Specialty Bracing clinics. This includes managing patient access, billing, coding, collections, and compliance. The director leads and mentors a team to optimize financial performance, reduce claim denials, and ensure adherence to all federal, state, and payer-specific regulations, including those from Medicare, Medicaid, and private insurers.

Responsibilities:

Strategic leadership and financial management:

• Develop and implement revenue cycle strategies to enhance operational efficiency, maximize cash flow, and achieve financial goals.
• Analyze revenue cycle key performance indicators (KPIs), such as days in accounts receivable (A/R), denial rates, and collection efficiency, and present reports to division leadership.
• Create and manage the revenue cycle budget, justifying variances and conducting cost-benefit analyses for new resource investment.
• Evaluate and implement revenue cycle technologies, including electronic medical records (EMR) and billing software, to automate and streamline workflows.

Billing and coding operations:

• Oversee the entire billing process, from charge capture and claims submission to payment posting.
• Ensure that all billing and coding practices align with current orthotic & prosthetic (O&P)-specific L-code and ICD-10 coding standards.
• Supervise the team responsible for managing and resolving claims, including rejected or denied bills.
• Stay up-to-date on changes in reimbursement rates, regulations, and billing requirements from all third-party payers.

Compliance and risk management:

• Ensure strict compliance with all federal, state, and local regulations, including HIPAA, Medicare, and Medicaid rules.
• Maintain extensive knowledge of regulatory requirements for government and managed care payers as they apply to O&P.
• Lead internal and external audits and develop corrective action plans for compliance deficiencies.
• Oversee the management of medical records and patient documentation to support accurate billing.

Team leadership and development:

• Lead, mentor, and evaluate the revenue cycle team, including contract, authorization, and billing specialists.
• Provide training and continuing education to clinical and administrative staff on proper coding, documentation, and revenue cycle procedures.
• Promote a collaborative, team-oriented environment both within the department and with other clinical and operational departments.

Qualifications and Skills:

• Bachelor's degree in a related field (master's often preferred) and 7–10 years of progressive healthcare revenue cycle experience, with at least 3 years in leadership.
• O&P-specific experience is highly desirable.
• Relevant certifications are beneficial.
• Necessary skills include expertise in medical billing, coding, and reimbursement, familiarity with relevant software (preferably Nymbl and Waystar), strong analytical, problem-solving, leadership, communication, and interpersonal skills, and knowledge of payer relations and contracts.

Benefits Offered for Eligible Employees:

• Medical Insurance
• Dental Insurance
• Vision Insurance
• Long & Short-Term Disability
• Life Insurance and AD&D
• Retirement Savings Plan
• Paid Time Off (PTO) & Holidays

Equal Opportunity Employer:

OPSB is proud in its commitment to creating a diverse workforce and providing equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, parental status, national origin, age, disability, citizenship status, genetic information or characteristics, marital status, status as a Vietnam era veteran, special disabled veteran, or other protected veteran in accordance with applicable federal, state and local laws, and any other characteristic protected by law.

This job description is not intended to be and should not be construed as an all- inclusive list of all the responsibilities and working conditions of the position. While it is intended to accurately reflect the position activities and requirements, management reserves the right to modify, add or remove duties and assign other duties as necessary.

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