Sr. Director, Billing and Reconciliation
Palco is a visionary company pioneering an emerging health-care movement that empowers people with disabilities and those aging to live independent and quality lives. Made possible by our amazing team, Palco provides technology and financial services to aid individuals and their families to thrive in their home and communities. Partnered with government agencies and fortune 500 managed care organizations across the country, we are dedicated to creating exceptional outcomes for our clients and the millions of people that count on them. We are a highly organized company that offers a solid work/life balance, autonomy, generous paid time off, bonus potential, and career advancement opportunities. Our staff make long-lasting impact on the lives of people every day.
The Sr. Director, Billing and Reconciliation is responsible for managing the billing department and ensuring efficient and accurate billing operations and compliance. The Sr. Billing Director is responsible for a team of Billing Specialists processing Medicaid billing claims and reconciliations for multiple government programs. We are seeking a strong, experienced leader with Medicaid billing experience to join our team.
Duties and Responsibilities
- Lead and Manage Billing Department staff, including hiring, training, and evaluating staff performance.
- Oversee the preparation and submission of accurate and timely billing.
- Identify and address any issues related to claim denials, rejections, underpayments, overpayments.
- Train staff on Medicaid Billing procedures.
- Perform Medicaid, Managed Care (MCO), and related claims processing and billing based on program policies.
- Develop, monitor, and adjust billing policies and procedures for billing for all programs, including for direct Medicaid and veteran related services and administrative fees through MM’S and/or insurance payors.
- Ensuring accuracy of invoicing to our programs.
- Reconciling billing issues.
- Submit valid 837 claims, receive 835 remittance advices, and process rebilling
- Prepare regular billing for all clients for management review.
- Adjudicate, reconcile, and resubmit claims for processing in a timely manner.
- Compile, analyze, and evaluate billing data.
- Ensure company compliance with state and federal tax and regulatory authorities. Staying up to date on changes.
- Prepare or provide support for various ad-hoc projects initiated by management.
- Work with and support all clients, partners, and staff in billing related issues.
- Develop working relationships with partners and staff.
- Provide outstanding customer service to clients and business partners.
- Comply with HIPAA and other federal and state requirements.
Education and Qualifications
- Bachelor’s degree required. Business degree with emphasis in accounting/finance preferred.
- Experience with Medicaid, MCO and Veteran billing required
- Four (4) years of relevant experience in an office setting required.
- Five (5) years of management experience preferred.
- Experience with HP, DXC Medicaid Billing systems preferred.
- Must have good organization skills, strong attention to detail, and work independently under tight deadlines
- Must have strong analytical and critical thinking skills.
- Must have a strong general understanding in tax, accounting, and finance areas.
- Must possess strong skills with email, internet, and Microsoft Office, including the use of Word, Excel, and file maintenance programs.
- Must have strong interpersonal and communication skills, both written and verbal.
Join Us
This position is a remote/work-from-home role. Enjoy the convenience of working from home and maximize your time by unplugging at the end of your workday.
Company benefits designed for you:
- Generous Paid time off.
- Quarterly/Annual bonus potential.
- Retirement Savings: We will support you as you save for your future.
- Career Growth Opportunities: We help you thrive, so together, we can grow. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint.
- Paid Training: Earn while you learn, and continue to grow with access to internal and external learning opportunities.
- Great Work Environment: We are proud of our company culture of collaboration and the recognition we’ve received for our diversity efforts.
When you join Palco, you are engaged in creating the future - both our company’s, the people we serve, and your own. We understand that our success is directly related to the success of our team. We strive to create a culture where you can:
- Bring your authentic self to work.
- Grow and thrive, both personally and professionally.
- Make a difference with our clients, in our communities, and with the millions of people we support.
- Experience work/life balance.
- Feel value and a greater purpose through the work you do.
Palco, Inc. is an Equal Employment Opportunity (EEO) employer and does not discriminate in any employer/employee relations based on race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.
