Director of Revenue Cycle
About The Position
The Director of Billing and Managed Care will oversee and manage all aspects of the billing operations and managed care contracts within PCC Community Wellness Center. Responsibility will be to ensure accurate and timely billing to our customers while maintaining compliance with company policies and regulatory requirements. The Director of Billing and Managed Care will lead a team of billing specialists and collaborate closely with other departments such as finance accounting and effective management of relationships with managed care organizations to optimize revenue and ensure compliance to streamline processes and optimize revenue collection.
Requirements
- Bachelor’s degree in Accounting, Finance, Business Administration, or related field or/equivalent to 5 years of experience in billing management or a similar role.
- Strong leadership skills with experience in managing and developing a high-performing team.
- In-depth knowledge of billing procedures, accounting principles, and regulatory standards.
- Excellent analytical and problem-solving abilities, and detail oriented.
- Effective communication skills to interact with internal teams, clients, and stakeholders.
- Strong knowledge of healthcare billing regulations (e.g., Medicare, Medicaid, HIPAA) and managed care contracting principles.
- Proven track record in negotiating managed care contracts and optimizing reimbursement rates.
- Ability to read and write proficiently using the English language.
- Excellent written and oral communication skills.
- Microsoft Office 2007/2010
Nice To Haves
- Preferably in the healthcare industry.
- Proficiency in billing software and ERP systems (e.g., SAP, Oracle) preferred.
- Certification in Billing or Revenue Management (e.g., Certified Billing and Coding Specialist) preferred.
- Inuvio Software preferred
Responsibilities
- Lead and mentor a team of billing specialists, ensuring they are motivated, trained, and equipped to perform their roles effectively.
- Foster a culture of accountability, collaboration, and continuous improvement within the billing department.
- Develop and implement billing procedures and policies to ensure accuracy and efficiency in billing operations.
- Monitor billing performance metrics and KPIs to track productivity, identify trends, and address any issues promptly.
- Work closely with finance and accounting teams to reconcile billing discrepancies and ensure accurate revenue recognition.
- Identify opportunities to optimize revenue collection processes and minimize billing errors.
- Lead negotiations with managed care organizations to establish favorable contract terms and reimbursement rates.
- Manage ongoing relationships with managed care partners, resolving issues and ensuring contract compliance.
- Analyze contract performance and financial impacts, recommending strategies for contract optimization and revenue enhancement.
- Stay informed about relevant regulatory requirements and ensure billing practices comply with industry standards and legal guidelines.
- Implement internal controls to mitigate billing risks and maintain audit readiness.
- Collaborate with other departments such as Finance, EHRS, Credentialing, and IT to resolve customer billing inquiries and issues.
- Participate in cross-functional projects aimed at improving overall business processes and customer satisfaction.
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What This Job Offers
Job Type
Full-time
Career Level
Director
