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 and team members 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