The Billing Director is a strategic partner responsible for overseeing the organization's financial lifecycle, from initial provider credentialing and pre-billing through final claims adjudication. This position will lead our revenue cycle operations is responsible for proactively alerting executive leadership to potential write-offs, developing cross-departmental workflows to minimize errors, and aggressively pursuing appeals when appropriate to safeguard and optimize organizational revenue.
This position offers the rare opportunity to move past repetitive routine. By managing a highly diverse payer mix, you will engage in intellectual problem-solving every day, build a robust professional network across the healthcare industry, and enjoy the creative freedom to design an optimized, modern revenue cycle department.
Key Responsibilities:
Manage the credentialing process to ensure that clinical providers are linked to the appropriate payers per their specifications
Pre-auditing billing with verification of completeness and accuracy of claims prior to billing
Ensuring all claims are submitted timely with a goal of zero errors
Accurately post all insurance claims
Serve as the dedicated, primary Point of Contact (POC) for all external payers
Timely follow up on claims denials, exceptions, or exclusions
Managing explanation of benefits (EOB) and alerting supervisor of unusual trends
Utilizing monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days
Regularly meeting with executive leaders to discuss and resolve reimbursement issues or billing obstacles
Assist with software configuration around billing coding, and billing matrices
Provide necessary development of workflows, procedures, and training needs for other departments
Achievement of Key Performance Indicators (KPI’s) at or above the 95% benchmark
Perform additional duties as requested around accounts receivable and grant management as defined by executive leadership
Maintains familiarity with regulations and governing bodies around Medicaid, MCO’s, MHRS, DBH standards
Qualifications:
Bachelor's degree required. Master's degree in Healthcare Administration, Business Management, or other relevant Human Health Services field highly preferred.
5-7 years of billing, billing management and account management experience in behavioral health, mental health, or clinic based setting.
Billing and coding certifications strongly preferred (e.g., CPB, CPC, CRCR)
Experience with behavioral health electronic medical record systems and configuration of billing matrices preferred
Benefits:
Affordable Medical, Dental, and Vision insurance.
401K Retirement Plan and Life Insurance.
Generous Paid Time Off (PTO), Sick Leave, and Paid Company Holidays.
Opportunities for leadership training and professional development.
Employee Assistance Programs (EAP) to support your professional and personal well-being.
Position:
Hybrid - 2 days in office, 3 days remote
Salary Range:
$95,000 - $110,000 based on experience