Job Description

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