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Head of Revenue Cycle Management

2 months ago

Columbus, Georgia, United States Zoe Pediatrics Full time

Position Overview:

The Head of Revenue Cycle Management plays a crucial role within our organization, tasked with the oversight and enhancement of our billing operations.

This position involves leading the Billing Division, ensuring adherence to Medicaid guidelines, evaluating commercial agreements, and upholding revenue cycle protocols and practices.

Furthermore, the Head of Revenue Cycle Management is responsible for recruiting, training, and retaining a proficient team of Revenue Cycle Experts.

This role reports directly to the Chief Operating Officer (COO) and works in close partnership with the Controller to ensure accurate cash collections and front desk operations.


Primary Responsibilities:

  • Contribute to the creation of the Key Management Report (KMR) to monitor billing performance indicators.
  • Oversee the Billing Division, ensuring effective and precise billing procedures.
  • Remain informed about all Medicaid Bulletins relevant to Georgia and Alabama Medicaid programs.
  • Engage in the analysis of profitability on all commercial agreements to optimize revenue.
  • Collaborate with the COO or designated personnel to minimize errors in the intake process.
  • Maintain the charge master for both Zoe Pediatrics (Zoe Peds) and Zoe Applied Behavior Analysis (Zoe ABA).
  • Formulate and uphold company revenue cycle policies and procedures to guarantee compliance and efficiency.
  • Manage staffing levels within the Billing Division, including the recruitment, training, and retention of Revenue Cycle Experts.
  • Partner with the COO and Controller to ensure accurate cash collections and front desk operations.
  • Execute other essential duties as required by the organization.

Qualifications:

  • Bachelor's degree required; Master's degree preferred but not mandatory.
  • Certification in Billing and Coding.
  • Credentialing/Certification preferred but not mandatory.
  • At least 5 years of experience in billing and collections.
  • Proficiency in managing electronic databases.
  • Valid driver's license and reliable transportation required.

Essential Skills:

  • Excellent verbal and written communication abilities.
  • Strong attention to detail and organizational capabilities.
  • Ability to meet deadlines and function in a fast-paced environment.
  • Proven positive attitude and interpersonal skills.
  • Compliance with company dress code and attendance policies.
  • Effective time management and multitasking skills.
  • Openness to feedback on work performance and ability to collaborate effectively within a team.

Billing Duties:

  • Ensure prompt billing of claims for Zoe Pediatrics and Zoe ABA across all payers.
  • Generate and dispatch patient bills weekly.
  • Maintain billing accuracy at 95% per biller.
  • Keep all encounter inventories at 90 days or less from the date of service across all lines of business.
  • Communicate with providers regarding claims inventories and outstanding claims actions.
  • Transmit all claims through the selected clearinghouse daily and resolve clearinghouse rejections swiftly.

Payment Posting:

  • Post payments daily and address ERA payer denials promptly.
  • Resolve un-reconciled balances daily to ensure financial accuracy.
  • Meet with CEO, COO, and Controller monthly to review and write off doubtful accounts.

Revenue Cycle Reporting:

  • Produce biweekly reports on various aspects of the revenue cycle, including encounters, denials, and front desk errors.

Job Type:
Full-time
Benefits:
  • 401(k)
  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:
8-hour shift
Day shift
Monday to Friday
Experience:
Medical billing: 5 years (Preferred)

Work Location:
In person