SAGA Diagnostics is an innovative multi-national life sciences company at the forefront of pioneering diagnostic solutions. Our proprietary MRD testing platform helps patients, oncologists, clinical researchers and drug developers to confidently detect residual disease post-curative intent therapy and monitor response to therapy with unprecedented sensitivity, specificity and turn-around time. Headquartered in Morrisville, NC, SAGA Diagnostics’ accomplished team comprises the industry’s most seasoned liquid biopsy experts, united in a shared promise to patients to detect and intercept molecular residual disease as early as possible, for every patient.

We are seeking an experienced Sr Director, Patient Billing to implement, lead and optimize our payor/patient billing operations. This role will oversee all aspects of billing, payor contract management, reimbursement optimization, and revenue integrity while ensuring compliance with federal and state regulations. The ideal candidate will have extensive experience working with Medicare, Medicaid, and commercial payors, as well as managing pre-authorization and appeals processes. This role will also be responsible for managing revenue cycle management systems, such as XiFIN, and developing a high-performance team to drive efficiency and financial performance.

Key Responsibilities

Revenue Cycle Management

• Lead all aspects of revenue cycle operations, including patient relations, billing, collections, claims processing, and denials management.
• Oversee the implementation, maintenance, and optimization of revenue cycle management systems (e.g., XiFIN) to ensure streamlined operations and accurate financial reporting.
• Develop and implement revenue cycle policies and procedures to enhance efficiency, minimize denials, and maximize reimbursements while maintaining compliance with applicable laws and regulations.
• Monitor key performance indicators (KPIs) to assess revenue cycle performance and implement corrective actions as needed.

Payor Relations & Contracting

• Establish and maintain strong relationships with government and commercial payors to optimize reimbursement rates and contract terms.
• Contribute to negotiations and contract management with payors, ensuring compliance with regulatory and operational requirements.
• Stay informed of evolving payor policies and reimbursement trends, proactively adjusting strategies to align with industry changes.

Pre-Authorization & Appeals Management

• Oversee and improve pre-authorization workflows to ensure timely approvals and minimize delays in reimbursement.
• Develop and manage an efficient appeals process to challenge incorrect denials and recover lost revenue.
• Collaborate with internal teams to ensure proper documentation and compliance with payor requirements.

Leadership & Team Development

• Build and mentor a high-performing revenue cycle management team, fostering a culture of accountability and excellence.
• Provide leadership and professional development opportunities to enhance team skills and industry knowledge.
• Work cross-functionally with finance, compliance, operations, and clinical teams to support organizational goals.

Requirements

Qualifications & Experience

• Bachelor’s degree in healthcare administration, finance, business, or a related field (Master’s degree preferred).
• Minimum 10+ years of experience in revenue cycle management, billing, and payor relations within a diagnostic or healthcare setting.
• Expertise in working with Medicare, Medicaid, and commercial insurance payors.
• Extensive knowledge of pre-authorization and appeals processes.
• Strong proficiency in revenue cycle management systems, such as XiFIN.
• Demonstrated ability to negotiate contracts and manage relationships with payors.
• Proven leadership skills with experience in building and developing high-performance teams.
• In-depth knowledge of healthcare regulations, reimbursement methodologies, and industry trends.
• Excellent analytical, problem-solving, and communication skills.

Benefits

• Competitive Compensation and company wide benefits plan
• Opportunities for career advancement and professional development.
• A collaborative and innovative work environment dedicated to improving oncology outcomes.

SAGA Diagnostics is an equal opportunity employer, fully committed to achieving a diverse and inclusive workplace that embraces and encourages applicants of every background. The company’s policy regarding equal employment opportunity means that all decisions regarding recruitment, hiring, benefits, wage and salary administration, scheduling, disciplinary action and termination will be made without unlawful discrimination on the basis of sex, gender, race, color, age, national origin, religion, disability, medical condition, genetic information, marital status, sexual orientation, gender identity or expression, citizenship status, pregnancy or maternity, veteran status, or any other status protected by applicable federal, state or local law. If you require reasonable accommodation in completing an application, interviewing, or otherwise participating in the employee selection process, please direct your inquiries to [email protected]. SAGA Diagnostics is a participant in the E-Verify program, learn more about the program and review our required disclosures here and here.