Revenue Cycle and Billing Operations Lead
PM Pediatric Care
Salary
💰 $80,000 - $100,000 per year
Job Level
Mid-LevelSenior
About the role
- Own the end-to-end customer billing processes and experience; manage all billing communications, ensuring a seamless process for both patients and health plans.
- Secure timely and complete reimbursements for the company by driving successful claims submissions through proactive efforts and technology enhancements.
- Claims Management: Follow up on claims submissions to monitor reimbursement, communicate directly with our RCM partners and health plans to resolve billing matters.
- Error Analysis: Research, analyze, and review submitted claim rejections and denials, identifying areas for correction and implementing necessary changes to improve accuracy.
- Reporting and Documentation: Handle and prepare insurance claims and billing reports, contributing to the month-end close processes.
- Stakeholder Liaison: Act as the primary liaison between internal stakeholders (including finance, product, and engineering teams) and external partners, ensuring effective communication and resolution of billing issues.
- Process Improvement: Identify pain points in our processes and systems, collaboratively arrive at requirements with stakeholders, and work with Engineering to provide feedback on developed solutions.
Requirements
- 3+ years of experience in medical billing, including claims submission and denials management
- Strong medical billing and claims knowledge
- Proficiency with Google Suite and Microsoft Excel (i.e. pivot tables, v-lookups)
- Proven curiosity and interest in enhancing systems and processes for improved claims collections and data visibility
- Strong written and verbal communication skills and comfort working with health plan partners to resolve payment issues
- Experience working with EMR and RCM software is a plus
- Able to work independently while managing projects cross-functionally
