[Hiring] DIRECTOR BILLING AND REVENUE CYCLE MANAGEMENT @Palco

Role Description

We are seeking a highly skilled and experienced Director of Billing and Revenue Cycle Management to oversee and optimize our Medicaid and Managed Care billing operations. The ideal candidate will have at least 3 years of experience in revenue cycle management and a track record of managing teams of 10-15 people. The Director will be responsible for:

• Day-to-day management of billing processes, ensuring timely and accurate billing.
• Addressing claim denials and overseeing collections.
• Collaborating across teams, training staff, and formalizing operational procedures.
• Maintaining a strong focus on performance metrics.

This is a remote position requiring strong technical skills, deep knowledge of Medicaid portals and EDI claims systems, and the ability to manage a growing team. The Director will work closely with payroll, client-facing teams, and IT to ensure smooth operations and resolution of billing issues.

Qualifications

• Advanced Excel skills, including proficiency with VLOOKUPs, pivot tables, and other formulas.
• 5+ years of experience in Medicaid billing and Managed Care programs, particularly in the home care space.
• Proven experience managing a team of 10-15 billing staff, with the ability to train, develop, and motivate the team.
• In-depth knowledge of Medicaid portals and EDI claims systems (837, 835, 276, 277, 834, 270, 271, 999).
• Strong experience with reconciliation processes and a solid understanding of billing, payments, and general ledger alignment.
• Ability to collaborate across departments (payroll, client-facing teams, IT, etc.) to streamline processes and resolve issues.
• Excellent critical thinking and problem-solving skills, particularly when addressing billing discrepancies and system issues.
• Strong training and development abilities, with experience in documenting and formalizing procedures.
• Ability to work independently and manage a team remotely.
• Previous experience with NetSuite or similar accounting software is a plus.

Requirements

• Lead and manage a billing team (10-15 people) in the home care space, ensuring timely and accurate billing submissions.
• Oversee the preparation and submission of Medicaid and Managed Care claims, including 837, 835, 276, 277, 834, 270, 271, and 999 files.
• Identify and address issues related to claim denials, rejections, underpayments, and overpayments, ensuring claims are resubmitted as needed.
• Develop and implement training programs for billing staff, ensuring they are well-versed in Medicaid and Managed Care billing procedures and company policies.
• Collaborate with cross-functional teams (e.g., payroll, client-facing teams, MCOs) to ensure seamless billing operations and efficient resolution of billing inquiries.
• Interface with IT teams to troubleshoot system issues and collaborate on technical solutions related to billing and claims processing.
• Monitor and track billing performance, ensuring collections targets are met and billing is completed timely each month.
• Reconcile billing accounts to the general ledger and ensure alignment between billing records and financial statements.
• Document and formalize billing procedures to improve efficiency, accuracy, and compliance with regulatory requirements.
• Analyze and interpret billing data, using Excel (VLOOKUPs, pivot tables) to provide actionable insights for management.
• Ensure compliance with all state and federal regulations (including HIPAA) and maintain up-to-date knowledge of Medicaid policies.
• Provide leadership in staff development, fostering a high-performance culture focused on accuracy, customer service, and team growth.

Benefits

• Generous Paid time off.
• Annual bonus potential.
• Retirement Savings: We will support you as you save for your future.
• Career Growth Opportunities: We help you thrive, so together, we can grow.
• Paid Training: Earn while you learn and continue to grow with access to internal and external learning opportunities.
• Great Work Environment: We are proud of our company culture of collaboration and the recognition we have received for our diversity efforts.
• Employer shared Health Insurance cost.
• Employer paid Disability Insurance.
• Employer paid Life and AD&D Insurance.
• Vision Insurance.
• Cancer Insurance.
• Voluntary Life Insurance.
• Paid Time Off.
• Remote work environment.
• Paid holidays.