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The Director of Billing leads claim production and submission across the healthcare system, covering both HB and PB services. This leader is responsible for ensuring accurate, timely, and compliant billing operations while optimizing revenue capture, reducing accounts receivable (A/R), improving first-pass claim acceptance, accelerating cash, and reducing billing-driven denials and avoidable write-offs. The Director standardizes billing workflows, controls, and performance management across facilities, service lines, and payor plans/policies, including integrated billing teams for research, transplant, and specialty (e.g., client/corporate bills, Department of Health programs) while leveraging automation and technology. The position works closely with Revenue Integrity, Patient Access, Health Information Management (HIM), Coding, Managed Care, Finance, IT, and Compliance, to ensure consistent system-wide billing performance and maintain regulatory compliance.
Qualifications
• Education: Bachelor's degree in Healthcare Administration, Business Administration, Finance, Management, or a related field preferred. A formal degree may be substituted with 10+ years of direct revenue cycle and supervisory experience.
• Experience: Minimum of 4 years of leadership experience managing hospital and/or professional billing operations with a four-year degree.
• Demonstrated experience with Epic and revenue cycle technologies.
• Proven success leading large teams through organizational change and process improvement initiatives.
• Epic Revenue Cycle Certification preferred.
• Deep billing domain expertise across Hospital Billing (HB) and Professional Billing (PB), including strong knowledge of:
- CMS and commercial billing regulations
- UB-04 and CMS-1500 claim forms
- National Correct Coding Initiative (NCCI)
- Medically Unlikely Edits (MUEs)
- Local Coverage Determinations (LCDs)
- National Coverage Determinations (NCDs)
• Strong leadership skills with the ability to manage, mentor, and motivate teams.
• Demonstrated performance management discipline, including:
- Key Performance Indicators (KPIs)
- Operational cadence
- Team accountability
• Strong change leadership capabilities with a continuous improvement mindset.
• Excellent communication and interpersonal skills.
• Working knowledge of:
- HIPAA compliance and privacy requirements
- Billing audit practices and expectations.
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