DIRECTOR BILLING & ACCOUNTS RECEIVABLE OPERATIONS

TriHealth, Inc.; Norwood (OH); On-site; USD 160,000 - 220,000; Full time

Job summary

TriHealth seeks a Director of Billing & AR Operations to lead claim submission, denial prevention and payer AR performance across the health system.

The role partners with Revenue Integrity, CDI, Coding and IT to accelerate reimbursement, reduce aging, and improve overall revenue cycle outcomes. Strong leadership and regulatory compliance are essential.

Qualifications

• 7–10 years of progressive healthcare experience; revenue cycle preferred.
• 5–7 years of leadership experience in a complex healthcare or revenue cycle setting.
• 1–2 years’ Epic Resolute Hospital/Professional Billing experience preferred.

Responsibilities

• Provide strategic and operational leadership for claim billing and payer AR operations.
• Collaborate across Revenue Integrity, Patient Access, Coding, CDI, Managed Care, Finance and IT.
• Improve denial prevention, timely submissions, aging reductions and cash performance.
• Lead workforce development and ensure regulatory compliance.

Skills

Healthcare billing knowledge

Payer adjudication processes

Revenue cycle analytics

Leadership & change management

Epic Resolute familiarity

Regulatory & compliance awareness

Executive reporting & stakeholder mgmt

Education

Bachelor's degree in Healthcare Administration or related field

Master's degree in Healthcare Admin/Finance/Accounting or related field

Job description

Job Overview

The Director, Billing & Accounts Receivable Operations provides strategic and operational leadership for claim billing and third-party payer accounts receivable operations across the health system. The Director is accountable for ensuring timely, accurate, and compliant claim submission; optimizing insurance receivable performance; resolving reimbursement barriers; and achieving key revenue cycle and financial performance outcomes.

The Director leads institutional and professional billing operations, claim edit resolution, and payer accounts receivable follow-up while partnering closely with Denials Management to improve denial prevention, resolution, and root-cause remediation. This position collaborates across Revenue Integrity, Patient Access, Coding, Clinical Documentation Integrity (CDI), Managed Care, Finance, Information Technology, and operational leadership to accelerate reimbursement, reduce avoidable aging, minimize revenue leakage, and improve overall revenue cycle performance.

Success in this role is measured through key performance indicators including clean claim performance, claim submission timeliness, accounts receivable days, aging distribution, denial prevention and resolution effectiveness, productivity and quality, cash performance, and reduction of preventable write-offs.

The Director is accountable for strategic leadership, operational and financial performance, workforce development, regulatory compliance, stakeholder partnership, and continuous improvement across Billing and Accounts Receivable operations.

Job Requirements

Education

• Bachelor’s degree in Healthcare Administration, Business Administration, Finance, Accounting, Health Information Management, or related field required.
• Master’s degree in Healthcare Administration, Business Administration, Finance, Accounting, Health Information Management, or related field preferred.

Experience

• 7–10 years of progressive healthcare experience required; Revenue Cycle experience preferred.
• 5–7 years of leadership experience required, preferably within a complex healthcare or revenue cycle environment.
• 1-2 years’ Experience with Epic Resolute Hospital Billing and/or Professional Billing operations preferred.

Knowledge, Skills & Abilities

• Strong knowledge of healthcare claim billing, reimbursement methodologies, payer adjudication processes, accounts receivable management, and denial prevention and resolution.
• Thorough understanding of Medicare, Medicaid, managed care, commercial insurance, governmental reimbursement requirements, CMS regulations, billing compliance requirements, and payer contract provisions.
• Strong analytical capabilities with the ability to interpret operational, financial, payer, and revenue cycle performance data and translate findings into actionable strategies.
• Demonstrated success leading large or complex operational teams through organizational change, process redesign, performance improvement, and transformation.
• Strong operational improvement, problem-solving, and process redesign capabilities.
• Working knowledge of Epic Resolute, payer portals, claim clearinghouses, reporting tools, and workflow management systems.
• Strong project management and change leadership capabilities.
• Excellent communication, presentation, relationship management, and executive reporting skills.
• Proficiency in Microsoft Excel, Word, and PowerPoint.

Preferred Certifications

• Certified Revenue Cycle Representative (CRCR), HFMA