Head of Revenue Cycle Management
Practice Area
Digital Health
Digital Health
Region
Anywhere
Anywhere
Location
Remote
Remote
Company Location
Miami FL
Miami FL
Position Id
46907
46907
Head of Revenue Cycle Management
Job Description
Description
We are seeking an experienced Director of Billing Operations and Revenue Cycle Manager to lead our revenue cycle and ensure seamless claims billing integration for our partners. This role requires deep expertise in health plan operations, particularly in implementing and managing claims billing for providers, ideally within the digital health sector. The ideal candidate brings a strong background in healthcare billing, health plan operations, and revenue cycle management, and is driven to create positive change in healthcare.
Responsibilities:
- Build and lead the revenue cycle process, including medical claims submission, ERA, and reconciliation, ensuring timely and accurate billing and collections processes.
- Lead the implementation and management of claims billing integrations with various health plans.
- Monitor key performance indicators (KPIs) related to revenue cycle efficiency and implement strategies for continuous improvement.
- Lead a team of Billing Operations and Revenue Cycle Managers, providing guidance on best practices, regulatory updates, and system enhancements.
- Collaborate with internal and external stakeholders to ensure seamless integration of billing systems with health plan platforms.
- Maintain up-to-date knowledge of payer requirements, reimbursement methodologies, and regulatory changes that impact claims processing.
- Ensure compliance with all applicable federal, state, and local regulations related to healthcare billing and revenue cycle management.
- Develop and implement policies and procedures to maintain compliance with health plan contracts and payer guidelines.
- Collaborate with cross-functional teams, including finance, operations, and IT, to streamline revenue cycle processes.
Qualifications:
- Bachelor's degree in Healthcare Administration, Business, Finance, or a related field. Master’s degree preferred.
- Minimum of 5-7 years of experience in revenue cycle management, preferably in the digital health or health plan/insurance/payor industry.
- Proven experience with health plans, including implementing and managing claims billing integrations.
- Strong understanding of healthcare reimbursement methodologies, payer contracts, and regulatory requirements.
- Proficient in revenue cycle management software and electronic health records (EHR) systems.
- Excellent leadership and team management skills.
- Strong analytical and problem-solving abilities.
- Exceptional communication and interpersonal skills.
Benefits:
- Competitive salary and bonus structure.
- Comprehensive health, dental, and vision insurance.
- 401(k).
- Flexible work schedule and remote work options.
- Opportunities for professional development and career growth.