Strategic Billing Operations Director

Shield HealthCare - Medical Supplies for Care at Home Since 1957; Santa Clarita (CA); On-site; USD 130,000 - 160,000; Full time

Benefits offered by this job

Medical, Dental, and Vision

401(k) with Company Match

Sick and Vacation Days

Flexible Spending Account

Life & Disability Insurance

Education Assistance

Employee Referral Program

Job summary

Shield HealthCare in Valencia, CA is seeking a Director of Billing Operations to lead the Billing Operations Department on-site. This role ensures timely submission of claims, drives department performance, and supports revenue goals while collaborating with internal teams and external payers.

The candidate will direct billing activities, optimize workflows, manage budgets, mentor staff, and ensure compliance with HIPAA and payer rules in a fast-paced environment.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business Administration, Finance or Accounting, or Health Information Management required; master’s degree preferred.
• 7+ years of experience in healthcare billing, adjudication, or revenue cycle operations.
• 4+ years of leadership experience managing large teams or multi-level departments.
• Proven ability to coach and mentor team, identifying areas for team and individual development.
• Strong knowledge of payer rules, government programs, and medical billing regulations.
• Experience with healthcare billing/claims systems highly preferred.
• Proficiency in Microsoft 365 (Excel, PowerPoint, Word, SharePoint, Teams).
• Advanced or Expert level of proficiency in MS Excel.

Responsibilities

• Direct all billing activities to ensure timely payment of claims.
• Establish, refine, and standardize workflows to maximize productivity, accuracy, and turnaround times.
• Ensure adherence to company policies, payer rules, and federal and state regulations.
• Serve as a liaison with Revenue Cycle, Billing, Coding, and Compliance departments, and external payers.
• Develop and execute short and long‑term strategic plans for the Adjudication Department.
• Manage departmental budget, staffing models, and resource allocation.
• Monitor denial patterns and write‑offs; implementing corrective action plans.
• Lead, mentor, coach, and evaluate direct reports.
• Support direct reports in the development and performance management of billing operations team.
• Conduct performance management actions as needed.
• Establish 90-Day Onboarding plan to support new employees in their role.
• Oversee departmental training programs to ensure staff competency in billing, payer rules, and regulatory updates.
• Partner with Learning & Development team to build departmental training plans.
• Handle multiple priorities with aggressive deadlines, ensuring appropriate follow-up and closure.
• Complete special projects supporting claim management of payments with internal and external stakeholders as assigned, supporting team and organizational objectives and continuous improvement initiatives.

Skills

Leadership

Healthcare billing

Payer rules

Analytical skills

Communication skills

Education

Bachelor’s degree in Healthcare Administration or related field

Master’s degree preferred

Tools

Microsoft Excel

PowerPoint

Word

SharePoint

Teams

Job description

Shield HealthCare in Valencia, CA is seeking a Director of Billing Operations to lead the Billing Operations Department on-site. This role ensures timely submission of claims, drives department performance, and supports revenue goals while collaborating with internal teams and external payers.

The candidate will direct billing activities, optimize workflows, manage budgets, mentor staff, and ensure compliance with HIPAA and payer rules in a fast-paced environment.