Job Description

The Director of Billing is responsible for the strategic oversight and operational performance of the billing department for a provider services group. This role ensures timely, accurate billing and collections while maintaining compliance with healthcare regulations and payer requirements. The Director will lead a team of billing and provider enrollment professionals, optimize billing processes, and collaborate with internal and external stakeholders to maximize revenue cycle efficiency.

Key Responsibilities:

• Oversee all day-to-day billing operations for the provider services group, including charge entry, claims submission, payment posting, and denial management.
• Develop and implement best practices for efficient billing workflows and revenue cycle performance.
• Monitor KPIs (e.g., days in A/R, denial rates, collection rates) and implement strategies for continuous improvement.
• Ensure compliance with federal, state, and payer-specific billing regulations, including Medicare and Medicaid guidelines.
• Work closely with physicians, clinical staff, and administrative leadership to ensure accurate charge capture and documentation.
• Lead, mentor, and manage billing and provider enrollment staff, fostering a culture of accountability, professionalism, and continuous learning.
• Collaborate with IT and EMR platform and vendors to optimize system performance and integrations.
• Serve as the key point of contact for audits, payer inquiries, and compliance reviews.
• Prepare and present regular billing performance reports to executive leadership.

Qualifications:

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field (Master’s preferred).
• Minimum of 7 years of progressive experience in medical billing, with at least 3 years in a leadership role.
• Deep understanding of physician billing, CPT/ICD coding, payer guidelines, and reimbursement models.
• Experience with electronic health records (EHRs) and practice management systems.
• Strong analytical skills with experience managing revenue cycle metrics and process improvement initiatives.
• Excellent leadership, communication, and interpersonal skills.
• CPC or CPB certification a plus.

Preferred Experience:

• Multi-specialty and outpatient provider services group billing.
• Experience working in a fast-paced, growth-oriented healthcare environment.
• Familiarity with telehealth billing, value-based care models, or risk-adjusted coding.

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