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
Senior Director, Billing Strategy & Optimization
Comcast
ABA Director of Billing
Behavioral Health Works
Director, Billing & Collections (Financial Services/TPA Exp.)
Ascensushr
NetSuite Associate Director - ARM/Suitebilling
Crosscountry Consulting
Clinical Specialist CRM - Tampa
Medtronic
Imaging Institute - Physician, Breast Radiologist
Highmarkhealth