Pomelo Care · 10 hours ago

Director, Revenue Cycle

United States

Full-time

Remote

Director/Executive

$150K/yr - $180K/yr

7+ years exp

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Responsibilities

Lead a team of medical coding and billing managers and specialists

Streamline all internal processes and infrastructure for encounter coding and billing as we rapidly scale

Collaborate with coding and billing team managers to build out trainings to support improved documentation for clinicians

Stay up to date with coding regulations, guidelines, and changes in Medicaid rules, ensuring compliance with coding requirements

Collaborate with our partnerships and customer success teams, as well as our health plan partners, on researching state-specific coding or billing related questions prior to health plan launches

Track and report on billing and coding team KPIs, including team productivity, clean claims rate, outstanding A/R, denial rates, etc.

Identify and implement process improvements to enhance efficiency and effectiveness in revenue cycle operations and maximize value generation for the business

Conduct regular audits to ensure accuracy of billing practices and no revenue or reporting leakage

Work closely with Finance team on revenue reporting and reconciliation

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Revenue cycle experienceMedical coding experienceCertified Professional Coder (CPC)CPT coding guidelinesICD-10 coding guidelinesMedicaid coding rulesMaternalChild healthTelehealth codingAthenahealth EHRObstetrics codingGynecology codingPediatrics coding