Billing & Collections Lead

The Pennant Group

1d

About The Position

The Billing and Collections Lead is responsible for the daily leadership of the teams managing all billing and post-billing collections functions. This hands-on leadership role requires expert knowledge of Medicare, Medicaid, and commercial payer regulations, strong denial and appeals expertise, and a strategic approach to accounts receivable management. The ideal candidate will balance precision in billing with assertiveness in collections to optimize cash flow and minimize denials and bad debt.

Requirements

• Minimum of 3 years of experience in healthcare billing and/or collections, with Home Health or Hospice experience strongly preferred.
• Minimum of 1 year of leadership or supervisory experience managing billing, collections, or accounts receivable teams.
• Deep understanding of Medicare and Medicaid billing and appeals processes.
• Proven ability to interpret EOBs, remittance advice, payer contracts, and denial reasons.
• Proficiency with major Home Health or Hospice EMR and billing systems (e.g., HCHB, WellSky/Kinnser, MatrixCare).
• Comprehensive knowledge of ICD-10 coding, institutional claim forms (UB-04/CMS-1450), and payer billing rules.
• Exceptional analytical and problem-solving skills with strong attention to detail.
• Proven ability to troubleshoot complex billing and payment issues.
• Assertive and persistent approach to collections with strong negotiation skills.
• Excellent written and verbal communication, maintaining professionalism under pressure.
• High level of integrity with a strong focus on regulatory compliance and continuous process improvement.

Nice To Haves

• Associate’s or Bachelor’s degree in Business, Accounting, Finance, or a related field.
• Certification in Medical Billing, Coding, or Revenue Cycle Management (e.g., CPC, COC, CRCR).

Responsibilities

• Team Leadership and Management: Lead, train, and mentor the billing and collections teams, setting performance goals, distributing workload, defining daily workflow, and providing coaching to ensure accuracy, productivity, and compliance across all functions.
• Claim Submission and Billing Oversight: Oversee the preparation, review, and compliant electronic submission of all claims (e.g., RAPs/NOEs, final claims, adjustments) to Medicare, Medicaid, and commercial payers, ensuring timely and accurate billing.
• Accounts Receivable (AR) Management: Direct end-to-end AR management, including payment posting, reconciliation, aging review, and follow-up activities, with a focus on reducing DSO and prioritizing the oldest and highest-dollar accounts.
• Denial, Rejection, and Appeal Management: Implement and oversee processes for the prompt research, correction, resubmission, and appeal of denied or rejected claims. Ensure all appeals are supported with complete and accurate documentation and address root causes to improve first-pass acceptance rates.
• Collections Strategy and Execution: Develop and execute strategic plans for collecting outstanding balances from Medicare, Medicaid, commercial payers, and self-pay patients, using a compliant, streamlined, and results-oriented approach.
• Payer and Patient Communication: Serve as the primary escalation point for complex payer issues, negotiating resolution of systemic payment discrepancies. Oversee patient financial counseling and self-pay collections, ensuring all communication is professional, empathetic, and compliant with FDCPA guidelines.
• Compliance and Audit Readiness: Ensure all billing and collections practices adhere strictly to CMS, state Medicaid, and commercial payer requirements, maintaining readiness for internal and external audits.
• Reporting and Analysis: Track, analyze, and report on key revenue cycle metrics, including denial rates, collection effectiveness, AR aging, and payer trends. Use data insights to identify opportunities for process improvement and upstream collaboration.
• Interdepartmental Collaboration: Work closely with Intake, Authorization, and Clinical Documentation teams to resolve eligibility, authorization, or documentation issues that impact billing and collections outcomes.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree