What are the responsibilities and job description for the DIRECTOR OF BILLING AND REVENUE CYLE MANAGEME position at Palco?
DIRECTOR OF BILLING AND REVENUE CYCLE MANAGEMENT
Palco is a visionary company pioneering an emerging health-care movement that empowers people with disabilities and those aging to live independent and quality lives. Made possible by our amazing team, Palco provides technology and financial services to aid individuals and their families to thrive in their home and communities. Partnered with government agencies and fortune 500 managed care organizations across the country, we are dedicated to creating exceptional outcomes for our clients and the millions of people that count on them. We are a highly organized company that offers a solid work/life balance, autonomy, generous paid time off, bonus potential, and career advancement opportunities. Our staff make long-lasting impact on the lives of people every day.
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 5 years of experience in the home care space and a proven 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:
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.
- Advanced Excel skills, including proficiency with VLOOKUPs, pivot tables, and other formulas.
- 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.
- Knowledge of HIPAA and other regulatory requirements for billing.
Preferred Qualifications:
- Experience with home care billing systems and Managed Care Organization (MCO) portals.
- 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.
- Quarterly/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’ve received for our diversity efforts.
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.
Palco, Inc. is an Equal Employment Opportunity (EEO) employer and does not discriminate in any employer/employee relations based on race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.
