DIRECTOR OF BILLING AND REVENUE CYCLE MANAGEMENTWe 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. Additionally, this role requires a critical thinker who can collaborate across teams, train staff, and formalize operational procedures while 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.
Key Responsibilities:- 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.
Required Qualifications:- Advanced Excel skills are required, 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 ideal
- 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.
Join Us- This position is remote/work-from-home role. Enjoy the convenience of working from home and maximize your time by unplugging at the end of your workday.
- Company benefits designed for you:
- 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. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint.
- 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.
Benefits package:- 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
When you join Palco, you are engaged in creating the future - both our company's, the people we serve, and your own. We understand that our success is directly related to the success of our team. We strive to create a culture where you can:
- Bring your authentic self to work.
- Grow and thrive, both personally and professionally.
- Make a difference with our clients, in our communities, and with the millions of people we support.
- Experience work/life balance.
- Feel value and a greater purpose through the work you do.
