Billing Services Director

🕒 Junho 24

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Ensemble Health Partners

SiteLinkedInTodas as Vagas

5001 - 10000 funcionários

💼 Consultoria

🛡️ Seguros

📦 Logística

💰 Private Equity Round em 2022-03

Consulting • Insurance • Logistics

A Ensemble Health Partners é uma das principais fornecedoras de serviços de gestão do ciclo de receita (RCM) para organizações de saúde. Eles oferecem uma solução RCM completa que ajuda hospitais, sistemas de saúde e grupos de médicos afiliados a otimizar seus ciclos de receita, reduzir recusas e pagamentos incorretos, e melhorar as experiências dos pacientes usando uma combinação de gestão especializada e tecnologia avançada. A Ensemble Health Partners utiliza operadores certificados e inteligência artificial para entregar resultados consistentes, melhorar as cobranças e apoiar o crescimento futuro dos provedores de saúde. Eles são reconhecidos por suas parcerias robustas com clientes e pelo compromisso em proporcionar aumento confiável de receita e economia de custos para seus clientes.

Descrição

• Lead day-to-day billing operations, including charge capture, claim submission, edits/work queues, and billing accuracy • Drive process improvements to enhance clean claim rate, reduce rework, and accelerate reimbursement timelines • Partner with Coding, A/R, and Denials teams to ensure alignment across the revenue cycle and reduce downstream issues • Monitor key performance indicators (KPIs) such as clean claim rate, billing lag, denial rates, and cash conversion metrics • Identify trends and root causes of billing errors, edit failures, and payer denials, implementing sustainable solutions • Ensure compliance with CMS regulations, payer guidelines, and internal policies across all billing functions • Oversee and standardize workflows, policies, and procedures to support consistency and scalability across teams • Serve as an escalation point for complex billing issues, payer disputes, and client concerns • Partner with Technology and Operations teams to optimize billing systems, automation, and reporting capabilities • Lead, mentor, and develop high-performing teams, fostering a culture of accountability and continuous improvement

🎯 Requisitos

• Bachelor’s degree required; Master’s degree preferred (Healthcare Administration, Business, or related field) • 7+ years of progressive leadership experience in healthcare billing, revenue cycle, or related operations • Strong knowledge of professional and/or hospital billing processes, workflows, and payer requirements • Demonstrated success improving billing performance metrics and operational efficiency • Experience leading multi-site or multi-client billing operations • Strong analytical and problem-solving skills with the ability to leverage data for decision-making • Proven ability to lead cross-functional initiatives and influence stakeholders at all levels • Excellent communication, leadership, and client-facing skills.

🏖️ Benefícios

• Healthcare • Time off • Retirement plans • Well-being programs • Professional development opportunities