Billing Director

Job Summary:

The Director of Billing is responsible for leading and managing the healthcare organization's billing operations to ensure accurate, compliant, and timely claims submission, reimbursement, and revenue collection. This position plays a key role in optimizing revenue cycle performance, maintaining regulatory compliance, and driving continuous process improvements in a fast-paced healthcare environment.

Key Responsibilities:

• Oversee all billing functions including charge entry, claims submission, payment posting, and denial management.
• Ensure timely and accurate submission of insurance claims (government, commercial, and managed care) in compliance with payer requirements and regulations.
• Lead a team of billing professionals; provide training, development, and performance evaluations.
• Partner with coding, compliance, and patient access teams to maintain accurate data flow and reimbursement.
• Monitor and analyze key performance indicators (KPIs) such as Days in A/R, denial rates, and clean claim rates to drive improvements.
• Ensure compliance with federal and state healthcare billing regulations, including HIPAA, Medicare/Medicaid rules, and payer-specific guidelines.
• Manage payer relationships and act as a liaison to resolve reimbursement issues or disputes.
• Implement best practices and technology enhancements to streamline billing processes and reduce errors.
• Prepare and present financial and operational reports to senior leadership.
• Stay current on industry trends, payer policy changes, and regulatory updates impacting healthcare billing.

Requirements:

• 7+ years of experience in healthcare billing or revenue cycle, with 3+ years in a leadership or director-level role.
• Strong understanding of healthcare reimbursement systems, including CPT, ICD-10, HCPCS, and DRG/APC payment models.
• Expertise in working with Medicare, Medicaid, and commercial insurance payers.
• Familiarity with EHR and billing systems.
• Proven leadership, problem-solving, and project management skills.
• Exceptional communication, organizational, and analytical abilities.

Preferred Qualifications:

• Certified Professional Biller (CPB), Certified Revenue Cycle Professional (CRCP), or similar certification.
• Experience in both inpatient and outpatient billing environments.
• Knowledge of value-based care and risk-based reimbursement models.

Job Type: Full-time

Work Location: On the road