Billing Director Homecare

Certified Home Health Agency (CHHA) – New York State

The Director of Billing is responsible for the overall management, accuracy, compliance, and performance of the CHHA billing and revenue cycle functions. This role ensures timely and accurate billing, reimbursement optimization, regulatory compliance with NYSDOH and CMS requirements, and effective coordination with intake, clinical, authorization, and finance departments. The Director of Billing plays a critical role in maintaining agency financial stability while supporting compliant patient care delivery.

Reports directly to the Chief Financial Officer (CFO), Administrator, or Director of Patient Services, as designated.

• Directly supervises billing staff, medical records staff, and authorization personnel (as applicable)
• Oversees training, performance management, and workflow efficiency within the billing department

• Billing & Revenue Cycle Oversight
  • Oversees all billing functions for CHHA services, including Medicare, Medicaid, Managed Care, Medicare Advantage, and commercial payers
  • Ensures accurate and timely submission of claims in compliance with NYSDOH, CMS, and payer-specific requirements
  • Monitors billing timeliness, denial rates, payment variances, and aging accounts receivable
  • Works collaboratively with finance to reconcile revenue, cash posting, and payer remittances
• Regulatory & Compliance Responsibilities
  • Ensures compliance with:
    • NYSDOH CHHA regulations
    • CMS Medicare Conditions of Participation
    • Medicaid billing and managed care requirements
  • Maintains readiness for NYSDOH and CMS audits and surveys
  • Ensures billing practices align with:
    • OASIS completion
    • Physician orders
    • Plan of Care certification and recertification
    • Visit documentation standards
  • Participates in corrective action plans related to billing, documentation, or compliance findings
• Interdepartmental Coordination
  • Works closely with:
    • Intake and Authorization teams to ensure services are authorized and billable
    • Clinical leadership to resolve documentation or order deficiencies
    • Quality Assurance to address audit findings and improve compliance
  • Identifies system or process gaps that impact billing accuracy or timeliness and implements solutions
• Data, Reporting & Performance Monitoring
  • Develops and reviews billing and revenue reports, including:
    • Denials and rejections
    • Authorization issues
    • Days in A/R
    • Missed or delayed billing opportunities
  • Provides regular performance reports to executive leadership
  • Uses data to identify trends, risks, and opportunities for improvement
• Staff Leadership & Development
  • Ensures billing staff are trained and competent in current billing rules and payer requirements
  • Establishes clear workflows, accountability, and productivity expectations
  • Supports ongoing education related to regulatory changes and payer updates

• Education
  • Bachelor’s degree in healthcare administration, business, finance, or related field preferred
  • Equivalent experience in CHHA billing may be considered
• Experience
  • Minimum 5 years of healthcare billing experience, with at least 3 years in home health (CHHA) billing
  • Demonstrated experience with:
    • Medicare home health billing
    • Medicaid and Managed Care billing in NYS
    • CHHA documentation and regulatory requirements
  • Prior supervisory or management experience required
• Knowledge & Skills
  • Strong working knowledge of:
    • NYSDOH CHHA regulations
    • CMS Medicare billing requirements
    • OASIS and Plan of Care requirements
  • Proficiency with home health billing systems (e.g., HCHB or similar)
  • Excellent analytical, organizational, and problem-solving skills
  • Strong communication and leadership abilities
  • Ability to work collaboratively across departments

• Primarily office-based with prolonged periods of computer use
• Ability to attend meetings and audits as required

• Accurate and timely billing
• Reduced denial rates and improved cash flow
• Audit readiness at all times
• Effective collaboration with clinical, intake, and finance teams

Compliance with all NYSDOH and CMS requirements