Director Of Billing

Job Summary:

Under the general supervision of the Director of Administration, the Director of Billing is responsible for the full revenue cycle operations and driving the continuous improvement in collections, payer reimbursement, and financial optimization. This position leads the billing department, streamlines processes, recruits and develops talent, and drives strategic improvements to reduce errors, accelerate cash flow, and strengthen organizational controls. This role works frequently with SUNY Upstate leadership, Epic Information Management & Technology (IMT) clients, insurance carriers and closely with Med Best operational management including the Director of Human Resources, and Director of Audit & Compliance.

This role serves as a key stakeholder in revenue cycle strategy, operational efficiency, regulatory compliance, and organizational growth.

• Supervise, direct and manage the billing department including supervisors and specialists.
• Monitor employee performance; conduct reviews, make recommendations for promotions and salary adjustments. Assist new supervisors with reviews to mentor and develop skills.
• Communicate clear expectations to employees. Provide ongoing feedback and coaching. Counsel employees; make recommendations for discipline, handle complaints and grievances.
• Provide ongoing training and development of billing supervisors and team leaders through regular operational meetings.
• Screen, select, and interview billing applicants and make recommendations for employment consideration. Utilize online recruitment avenues to advertise and contact candidates.
• Organize and drive regular new hire training program and competency monitoring.
• Develop and execute billing strategies that improve accuracy, efficiencies, and drive cash flow and reimbursement.
• Establish key performance indicators (KPIs) to monitor billing performance and lead continuous workflow improvement initiatives.
• Collaborate with both client and operational leadership to align billing operations with revenue cycle goals.

• Monitor daily, weekly, and monthly billing metrics and reporting to communicate results.
• Analyze payer AR and balance trends, denial patterns, and reimbursement variances to identify root cause issues and execute corrective actions.
• Spearhead initiatives that drive reimbursement, minimize AR and denials, and strengthen collections.
• Prepare ad hoc reports for the client(s), supervisors, and staff. Assist with report creation and interpretation.

• Ensure compliance with CMS, Medicaid, commercial payer rules, HIPAA, and all federal/state regulations.
• Work closely with Director of Audit & Compliance and drive internal audits, documentation standards, and corrective action plans.
• Maintain knowledge of carrier regulations, policies and procedures that support compliant billing and coding practices.
• Interact with various third-party payors on an as needed basis.

Must have a thorough understanding of both ICD-10 and CPT coding. Must understand coordination of insurance benefits. Must be an effective leader in assigning duties and monitoring completion. Must have thorough knowledge of charge and payment posting, insurance AR follow up, denial management, and collection process. Must have clear understanding of Workers’ Compensation. Must be able to master the use of various billing platforms.

Must be able to interact and communicate effectively with other healthcare professionals including client and physician leadership, office staff, patients and public.

Perform other duties as assigned/requested.

Bachelor's degree in Healthcare Administration, Business, Finance, or related field and 5-7+ years of progressive medical billing experience or equivalent combination of education and experience required.

• Extensive experience with Epic electronic medical records and the EPIC Resolute professional billing application.
• 5–7+ years of progressively responsible experience in medical billing, ambulatory operations, revenue cycle management, or a related healthcare financial environment or revenue cycle experience.
• 3-5+ years of leadership and supervisory experience with demonstrated success managing, developing, and retaining high-performing teams.
• Strong knowledge of healthcare payer rules, reimbursement methodologies, revenue cycle operations, and applicable compliance requirements.
• Proven success of improving key performance…