Director of Revenue Cycle

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Job Description

Job Description
Gadzoom Health is a growing Medical Directorship Group dedicated to providing exceptional care to patients in skilled nursing facilities. We are committed to delivering high-quality services and improving the health outcomes of our patients. Our team consists of skilled professionals who are passionate about making a difference in the lives of others.

We are seeking a dynamic and experienced Director of Revenue Cycle to build and lead a billing team responsible for managing all billing operations for Medicare, Medicaid, and various insurance providers for our doctors and advanced practice providers within skilled nursing facilities. This Director will play a critical role in ensuring accurate and timely billing processes, maximizing revenue collection, and maintaining compliance with regulatory requirements.

Key Responsibilities:
1. Billing Operations Management:
  • Oversee the end-to-end billing process for Medicare, Medicaid, and insurance claims submitted by doctors and advanced practice providers.
  • Manage and monitor over $1.2 million in monthly revenue, ensuring timely and accurate charge capture, claim submission, and payment posting
  • Develop and implement billing workflows
2. Compliance:
  • Ensure full compliance with Medicare, Medicaid, and insurance billing regulations, including coding guidelines and documentation requirements.
  • Stay up to date with industry changes in billing regulations and implement necessary updates to policies and procedures.
  • Conduct regular audits to ensure billing integrity and proactively address compliance risks
3. Team Leadership and Development:
  • Build and lead a team of billing professionals, setting clear expectations, while providing coaching and supporting professional growth
  • Conduct performance evaluations and provide constructive feedback to team members
  • Foster a collaborative, high performance culture focused on excellent care and operational success
4. Cross Functional Collaboration:
  • Collaborate with internal stakeholders, including clinical staff, administrators, and finance teams, to improve communication processes and resolve billing-related issues
  • Build and maintain positive relationships with external stakeholders, including Medicare, Medicaid, and insurance representatives, to facilitate efficient billing processes and resolve reimbursement issues.

Qualifications:
  • Minimum of 5 years of experience in healthcare billing, with specific experience in billing for Medicare, Medicaid, and insurance claims for a physician's practice.
  • Proven experience in developing or implementing billing systems, tools, or workflows to improve operational efficiency and revenue capture.
  • Demonstrated experience managing large-scale revenue cycle operations, including oversight of A/R and deposit reconciliation.
  • In-depth knowledge of Medicare and Medicaid billing regulations, including CMS guidelines and documentation practices.
  • Proven leadership skills with the ability to build and lead high performing teams
  • Excellent communication and interpersonal skills, with the ability to effectively engage internal and external stakeholders
  • Strong problem solving abilities and an analytical mindset, capable of reporting and interpreting data from revenue cycle reports
  • Certified Professional Coder (CPC) or Certified Billing and Coding Specialist (CBCS) certifications a plus

Benefits:
  • Comprehensive benefits package including health insurance, dental, vision, and more
  • Health savings account
  • Competitive salary commensurate with experience
  • Opportunities for professional development and career advancement within a growing healthcare organization

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Location:
Lehi
Category:
Finance And Insurance

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