Billing Director

Hillcrest Children & Family Center; Washington (District of Columbia); Hybrid; USD 95,000 - 110,000; Full time

Benefits offered by this job

Medical, Dental, Vision insurance

401K Retirement Plan

Paid PTO and Holidays

Professional development

Employee Assistance Programs

Job summary

Hillcrest Children & Family Center is seeking a Billing Director to strategically oversee our financial lifecycle from credentialing through final claims adjudication. You will lead revenue cycle operations, alert leadership to potential write-offs, and optimize cross-department workflows to minimize errors.

In this role you will manage a diverse payer mix, engage in problem-solving, and pursue appeals to safeguard organizational revenue.

Qualifications

• Bachelor's degree required.
• 5-7 years of billing, billing management, and account management experience in behavioral health.
• Billing and coding certifications preferred (e.g., CPB, CPC, CRCR).
• Experience with behavioral health EMR systems and configuration of billing matrices preferred.

Responsibilities

• Manage credentialing to link clinical providers to payers per specifications.
• Pre-auditing billing with verification of completeness and accuracy of claims prior to billing.
• Ensure all claims are submitted timely with a goal of zero errors.
• Accurately post all insurance claims.
• Serve as the dedicated, primary point of contact for all external payers.
• Timely follow up on claims denials, exceptions, or exclusions.
• Manage explanation of benefits (EOB) and alert supervisor of unusual trends.
• Use monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days.
• Regularly meet with executive leaders to discuss reimbursement issues or billing obstacles.
• Assist with software configuration around billing coding, and billing matrices.
• Provide development of workflows, procedures, and training needs for other departments.
• Achieve KPI targets at or above the 95% benchmark.
• Perform additional duties around accounts receivable and grant management as defined by leadership.
• Maintain familiarity with Medicaid, MCOs, MHRS, DBH standards.

Skills

Billing management

Account management

Leadership

Education

Bachelor's degree

Master's degree in Healthcare Administration or related field

Tools

Behavioral health EMR

Billing matrices configuration

Job description

The Billing Director is a strategic partner responsible for overseeing the organization's financial lifecycle, from initial provider credentialing and pre-billing through final claims adjudication. This position will lead our revenue cycle operations is responsible for proactively alerting executive leadership to potential write-offs, developing cross-departmental workflows to minimize errors, and aggressively pursuing appeals when appropriate to safeguard and optimize organizational revenue.

This position offers the rare opportunity to move past repetitive routine. By managing a highly diverse payer mix, you will engage in intellectual problem-solving every day, build a robust professional network across the healthcare industry, and enjoy the creative freedom to design an optimized, modern revenue cycle department.

Key Responsibilities

• Manage the credentialing process to ensure that clinical providers are linked to the appropriate payers per their specifications
• Pre-auditing billing with verification of completeness and accuracy of claims prior to billing
• Ensuring all claims are submitted timely with a goal of zero errors
• Accurately post all insurance claims
• Serve as the dedicated, primary Point of Contact (POC) for all external payers
• Timely follow up on claims denials, exceptions, or exclusions
• Managing explanation of benefits (EOB) and alerting supervisor of unusual trends
• Utilizing monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days
• Regularly meeting with executive leaders and team members to discuss and resolve reimbursement issues or billing obstacles
• Assist with software configuration around billing coding, and billing matrices
• Provide necessary development of workflows, procedures, and training needs for other departments
• Achievement of Key Performance Indicators (KPI's) at or above the 95% benchmark
• Perform additional duties as requested around accounts receivable and grant management as defined by executive leadership
• Maintains familiarity with regulations and governing bodies around Medicaid, MCO's, MHRS, DBH standards

Qualifications

• Bachelor's degree required. Master's degree in Healthcare Administration, Business Management, or other relevant Human Health Services field highly preferred.
• 5-7 years of billing, billing management and account management experience in behavioral health, mental health, or clinic based setting.
• Billing and coding certifications strongly preferred (e.g., CPB, CPC, CRCR)
• Experience with behavioral health electronic medical record systems and configuration of billing matrices preferred

Benefits

• Affordable Medical, Dental, and Vision insurance
• 401K Retirement Plan and Life Insurance
• Generous Paid Time Off (PTO), Sick Leave, and Paid Company Holidays
• Opportunities for leadership training and professional development
• Employee Assistance Programs (EAP) to support your professional and personal well-being

Position: Hybrid - 2 days in office, 3 days remote

Salary Range: $95,000 - $110,000 based on experience