Manager, Pre-Billing Revenue Cycle Operations, Home Health

Requirements

• Exemplifies characteristics of The BAYADA Way: compassion, excellence and reliability.
• Bachelor's degree in Healthcare Administration, Business, Nursing, or related field (or equivalent experience).
• Five (5)+ years of revenue cycle experience, with at least two to three (2-3) years in home health or post-acute care.
• Demonstrated experience in front-end revenue cycle functions
• Strong knowledge of Medicare home health requirements and Patient-Driven Groupings Model (PDGM).
• Proven leadership and team management experience.
• Experience with home health Electronic Medical Record (EMR) platforms - e.g., Homecare Homebase (HCHB)
• Advanced Microsoft Office and data analysis skills.
• Strong written and verbal communication skills, attention to detail, and comfort interacting with all levels of management
• Ability to read, write and effectively communicate in English.
• PRIMARY RESPONSIBILITIES:
• Demonstrate and communicate the core values of BAYADA and The BAYADA Way.
• Intake & Patient Access Oversight
• Ensure complete and accurate insurance verification before start of care (SOC)
• Evaluate referrals for financial and reimbursement risk, including high-risk non-Medicare cases and high out-of[1]pocket (OOP) exposure.
• Partner with clinical and sales teams to ensure appropriateness of admissions and financial viability.
• Develop and implement front-end gatekeeping processes to avoid high-risk admissions where reimbursement is unlikely.
• Develop or update training materials, guides, and reference documents to support team effectiveness.
• Billing Readiness & Revenue Cycle Time Optimization
• Drive reduction in charge lag/days to bill.
• Support Notice of Admission (NOA) timeliness to prevent penalties and lost revenue.
• Revenue Integrity & Risk Mitigation
• Monitor and mitigate risk of non-payment, with emphasis on intake-related drivers.
• Provide write-off and adjustment oversight, including root cause analysis.
• Partner with billing and collections teams to resolve systemic front-end issues impacting reimbursement.
• Analyze trends in front-end errors contributing to denials or delayed billing.
• Data Analytics and Reporting
• Develop, track, and report on key performance indicators, including:
• Non-payment risk trends
• Authorization turnaround times
• Eligibility accuracy
• Charge lag and days-to-bill
• Front-end driven denial rates
• Perform data analysis to identify trends and improvement opportunities
• Implement process improvements based on data insights.
• Demonstrate solid performance or exceed performance standards in key job dimensions/attributes as defined on the Performance Appraisal for Office Staff
• Perform related duties, or as required or requested by supervisor
• BAYADA believes that our employees are our greatest asset:
• Base Salary: $ 72,000-85,000 / year depending on qualifications
• Quarterly Bonus Opportunity
• BAYADA offers a comprehensive benefits plan that includes the following: Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with company match, direct deposit and employee assistance program
• To learn more about BAYADA Benefits, click here
• As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates.
• BAYADA is celebrating 50 years of compassion, excellence, and reliability. Learn more about our 50th anniversary celebration and how you can join in here .

Benefits

Additional Information

The Manager, Pre-Billing Revenue Cycle Operations, is responsible for overseeing pre-billing and intake-related revenue cycle functions within a home health organization. This role ensures accurate patient intake, insurance verification, and related problem resolution to support timely reimbursement, regulatory compliance, and optimal cash flow. This position plays a critical role in reducing denials, improving clean claim rates, and ensuring operational excellence in the front-end revenue cycle processes specific to home health services.

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