Director of Billing

Primary Responsibilities and Essential Functions of Position:

• Lead and manage the full Medicaid revenue cycle, including claim submission, rebilling, payment posting, denial management, and accounts receivable reconciliation.
• Ensure timely claim submission and reimbursement optimization across all Medicaid-funded programs and other non-Medicaid programs (e.g., private pay, ISS).
• Monitor aging accounts receivable and implement strategies to maintain optimal collection timelines.

• Develop and monitor KPIs for billing operations, including:
• Clean claim rate
• Days in accounts receivable
• Denial rates and root cause trends
• Claims submission timeliness
• Reimbursement cycle times
• Billing productivity metrics
• Utilize the Millin system reporting and data analytics tools to analyze billing performance and identify opportunities for revenue improvement.
• Produce regular billing analytics reports and dashboards for Fiscal leadership, highlighting operational trends, revenue performance, and risk areas.

• Lead, mentor, and supervise the billing team to ensure high performance, accuracy, and accountability.
• Establish performance expectations and productivity metrics for billing staff.
• Support professional development and cross-training to strengthen team capacity and operational resilience.

• Ensure compliance with all Medicaid regulations, billing policies, and payer requirements.
• Oversee internal billing audits and coordinate preparation for external Medicaid or regulatory audits.
• Maintain up-to-date knowledge of Medicaid regulatory changes and reimbursement guidelines.

• Evaluate billing workflows and implement process improvements to reduce errors, increase automation, and improve reimbursement turnaround.
• Collaborate with IT and Fiscal to optimize use of the Millin billing system, including reporting functionality and workflow configuration.
• Identify opportunities for system enhancements, data integrity improvements, and operational efficiencies.

• Partner with program leadership, clinical teams, and fiscal staff to resolve billing issues and strengthen documentation processes that support compliant billing.
• Serve as the primary liaison with Medicaid representatives and external partners related to billing and reimbursement matters.

• Bachelor’s degree in Accounting, Finance, Healthcare Administration, or a related field required.
• Minimum 7–10 years of healthcare or human services billing experience, including at least 3–5 years in a leadership position overseeing Medicaid billing operations.
• Demonstrated experience managing billing operations using Millin or comparable Medicaid billing and revenue cycle platforms.
• Advanced Excel skills experience required (e.g., VLookup, Pivot Table).
• Strong experience developing and monitoring billing key performance indicators (KPIs), operational dashboards, and performance metrics.
• Advanced knowledge of Medicaid billing regulations, claim submission protocols, rate structures, and payer requirements.
• Proven ability to analyze billing data to identify revenue unaccounted loss of income due to underbilling, unbilled, errors, denial trends, and process improvement opportunities.
• Strong analytical, leadership, and communication skills with the ability to translate complex billing data into actionable insights.
• Experience implementing workflow improvements and automation within billing or revenue cycle processes.
• Experience managing billing operations in a human services, behavioral health, or nonprofit environment preferred.
• Demonstrated ability to train, mentor, and develop billing staff while promoting accountability and performance management.
• Familiarity with Medicaid audits, regulatory reporting, and compliance oversight.

• Rewarding Work in a team environment.
• Paid vacation, sick, personal days, and holidays.
• 403(B) retirement plans with employer contribution.
• Health, dental, vision and life insurance.
• Employee Assistance Program (EAP).
• Flexible spending account (Dependent Care, Medical, Parking, and Transit).
• Employee Appreciation Programs and Events.
• Tuition Assistance Program.
• Professional Development opportunities.
• Wellhub Discount
• Verizon Wireless Discount.
• BJs Membership discount.
• Discounts on Broadway tickets, movie tickets, theme parks, sporting events, gift certificates & more