Director, Billing and Accounts Receivable

Title:

Director, Billing and Accounts Receivable

Reports to:

VP, Credentialing and Billing Classification:
Director

Location:

Boston (Hybrid)
Job description revision number and date: V2.0; 4.24.25

Organization

Summary:

Community Care Cooperative (C3) is a 501(c)(3) non-profit multi-service organization governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We fulfill two primary business functions for the FQHCs we work with. First, we are an FQHC-led accountable care organization (ACO); second, we are a Management Services Organization (MSO) for FQHCs.As

an ACO, we negotiate value-based payor contracts on behalf of our FQHCs, hold and operate those contracts (including fulfilling many compliance, financial management, and population health management functions), and maximize the return to FQHCs of any incentive dollars earned. We are proud to be the market leader in the Mass Health ACO Program. We are the largest Medicaid ACO in Massachusetts, and we operate a variety of business offerings nationwide.

As an MSO, we (along with our subsidiary companies, which are also FQHC-led non-profits) provide several financial, operational, and technological services to groups of FQHCs. These services include Epic EHR licensing and implementation; pharmacy operations consulting as well as the building and direct operation of on-site retail pharmacies; billing and credentialing; employer-sponsored insurance; and others.

We are a fast-growing, dynamic organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.

Job Summary:

This position provides leadership and oversight to the billing and accounts receivable activities for our FQHCs that are on our instance of Epic and/or in our Share Services model. The ideal candidate will lead and manage a team of billing and operational resources, ensuring compliance with state and federal guidelines, optimize accounts receivable performance, and provide strategic support to both C3 and our FQHCs financial goals.

The position collaborates with the Revenue Integrity Director and Credentialing Manager particularly around claim form logic, denial management, and optimal Epic workflow and reporting. The Director of Billing and Accounts Receivable should have a background in FQHC billing requirements, proficiency in using Epic, and a solid understanding of healthcare billing regulations, particularly in Massachusetts.

Responsibilities:

Supervises and mentors the billing team, providing training and support to maintain high standards of accuracy and productivity

Helps create the vision for the C3 to be the go-to resource for an affordable and efficient MSO in Billing and Credentialing Facilitates positive collaboration with other leaders within the MSO, across C3, and at the Health Centers Conduct regular performance reviews and address performance issues promptly

Foster a collaborative and professional team environment

Remains current on billing codes, payer requirements, and policy changes

Establishes, updates, and maintains policies and procedures governing billing and collections, ensuring the documentation is always current, complete, and user-friendly

Identifies process and technology improvements to improve the effectiveness and efficiency of revenue cycle operations. Collaborates with internal and external constituents to execute improvements

Oversees all AR including insurance and self pay Oversees daily billing operations for the FQHC(s), ensuring accurate and timely processing of claims

Monitors and analyzes billing processes to identify areas for improvement and implement…