Director of Billing Certified Home Health Agency

Marquis Home Care; City of Albany (NY); On-site; USD 120,000 - 150,000; Full time

Job summary

Marquis Home Care is seeking a Director of Billing to oversee the hospital home health billing and revenue cycle, ensuring accurate submissions to Medicare, Medicaid, and commercial payers. The role partners with intake, clinical, and finance to optimize reimbursements and maintain audit readiness.

The candidate will lead a billing team, ensure regulatory compliance with NYSDOH and CMS, and drive performance metrics such as denial reduction and days in accounts receivable.

Qualifications

• Bachelor’s degree in healthcare administration, business, finance, or related field preferred.
• Equivalent CHHA billing experience may be considered.
• Minimum 5 years in healthcare billing; 3+ years in CHHA billing.
• Prior supervisory or management experience required.
• Strong knowledge of NYSDOH CHHA regulations and CMS billing rules.
• Experience with Medicare, Medicaid, and managed care billing in NYS.
• Proficiency with home health billing systems (e.g., HCHB).

Responsibilities

• Oversee CHHA billing and revenue cycle for Medicare, Medicaid, and other payers.
• Ensure timely and accurate submission of claims per NYSDOH and CMS.
• Monitor denials, days in AR, and aging; coordinate with finance.
• Prepare regular billing performance reports for leadership.
• Collaborate with intake, clinical, and QA to improve compliance.
• Lead training and development of billing staff.
• Prepare for NYSDOH and CMS audits and surveys.
• Identify process gaps and implement improvements.

Skills

Billing experience

Leadership

Analytical skills

Communication

Regulatory knowledge

OASIS and regulatory awareness

Team leadership

Cross-department collaboration

Regulatory compliance

Education

Bachelor's degree in healthcare administration

Equivalent CHHA billing experience

Tools

HCHB system

Job description

Director of Billing (IN HOUSE POSITION)

Certified Home Health Agency (CHHA) – New York State

Position Summary

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.

Reporting Relationship

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

Supervisory Responsibilities

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

Essential Duties And Responsibilities

• 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

Qualifications

• 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

Physical & Work Requirements

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

Performance Expectations

• 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