Company Overview
Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team, from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff, is driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs because we know that health requires care for the whole person.
Job Title & Role Description
The Director, Revenue Cycle is the enterprise owner of end-to-end revenue cycle performance across Upward Health’s operations. This role is accountable for the accuracy, efficiency, and scalability of all revenue cycle functions, including charge capture, coding, billing, claims submission, denial management, and collections.
This position operates as a hands-on leader, combining operational oversight with data-driven performance management in a complex, multi-system environment. The Director is responsible for optimizing workflows across Athenahealth and third-party platforms, while leveraging analytics, automation, and emerging AI tools to enhance outcomes and reduce administrative burden.
The role partners closely with finance, operations, clinical, and IT leadership to ensure that revenue cycle processes are aligned with organizational goals and evolving payer requirements. The Director will also lead teams across billing, coding, and accounts receivable functions, establishing a culture of accountability, continuous improvement, and data-driven decision-making.
Skills Required:
7–10+ years of progressive experience in revenue cycle management
Direct, hands-on experience with Athenahealth
Advanced Excel skills, including data modeling and reporting automation
Strong analytical mindset with high attention to detail
Proven track record improving revenue cycle KPIs and operational efficiency
Experience implementing process improvements and workflow automation
Demonstrated ability to quickly learn and adapt to new systems
Experience leading teams within a healthcare billing or revenue cycle environment
Preferred
Experience in value-based care or risk-based contracting environments
Familiarity with EDI transactions (835/837) and clearinghouse operations
Experience leveraging AI or automation tools in healthcare operations
Bachelor’s degree in Healthcare Administration, Finance, or related field (Master’s preferred)
Key Responsibilities
Revenue Cycle Operations
Oversee all aspects of the revenue cycle, including intake, eligibility verification, coding, charge entry, claims submission, AR follow-up, denial management, and payment posting
Establish and monitor KPIs such as days in AR, denial rate, first-pass resolution rate, and net collection rate
Identify root causes of revenue leakage and implement corrective actions
Ensure timely, accurate claims submission and reimbursement across all payer types
Athenahealth Optimization
Serve as the internal subject matter expert for Athenahealth practice management and billing workflows
Configure and optimize system rules, edits, and reporting to maximize efficiency and clean claim rates
Partner with IT and operations on enhancements, automations, and integrations
Troubleshoot system issues and drive continuous improvement in platform utilization
Data Analytics & Reporting
Leverage advanced Excel capabilities (pivot tables, XLOOKUP, Power Query) to analyze large datasets
Build and maintain dashboards and reporting tools for leadership
Translate complex data into clear insights and operational improvements
Ensure data integrity across systems and reporting outputs
Process Improvement & Automation
Design, document, and standardize SOPs across the revenue cycle
Identify and implement workflow improvements to reduce manual intervention
Drive scalable process enhancements that support organizational growth
Establish measurable performance metrics and accountability standards
AI & Workflow Innovation
Identify and implement AI-enabled tools to optimize revenue cycle processes (e.g., denial prediction, coding support, automation)
Evaluate emerging technologies and vendors for efficiency and accuracy improvements
Lead pilots and deployments of automation solutions that reduce administrative burden
Develop a forward-looking roadmap for AI integration across revenue cycle functions
Compliance & Risk Management
Ensure compliance with payer requirements, CMS guidelines, and regulatory standards (including HIPAA)
Monitor audit outcomes and implement corrective actions
Maintain accurate documentation and coding integrity
Leadership & Team Development
Lead and develop teams across billing, coding, and AR functions
Establish performance expectations and provide ongoing coaching
Foster a culture of accountability, continuous improvement, and operational excellence
Partner cross-functionally with clinical, operational, and finance leaders
Key Competencies
Detail-oriented and highly organized
Data-driven decision-making
Strong systems thinking and process design capabilities
Technologically forward, with a focus on AI and automation
Effective communicator with ability to translate data into action
Results-driven with strong accountability and execution focus
