Director of Billing

Centerpoint Health is an FQHC seeking a Director of Billing for our community health center. We have locations in Franklin and Middletown, OH. We provide services in primary health care, ob-gyn, and behavioral health.

Job Function:

The Director of Billing is responsible for overseeing and optimizing all aspects of the revenue cycle, including billing, coding, insurance verification, claims processing, collections, paneling, and credentialing. This position ensures efficient workflows and compliance with regulatory requirements to maximize reimbursement and minimize denials. The Director collaborates with financial and clinical teams to analyze performance metrics, identify opportunities for process improvement, and implement strategies that enhance net patient revenue.

Organizational Relationships:

The Director of Billing reports to the CFO. This role supervises managers and staff across billing, coding, and collections departments. The Director works closely with leadership to align revenue cycle goals with organizational objectives and supports staff development through training and mentorship.

The Director of Billing assists the CFO in evaluating revenue cycle processes and formulating policies that promote financial stability and growth. The Director is expected to maintain up-to-date knowledge of healthcare regulations, payer requirements, and best practices relevant to revenue cycle operations.

Essential Duties and Responsibilities:

• Direct and manage all functions of the revenue cycle, including billing, coding, insurance verification, collections, insurance paneling, and practitioner credentialing.
• Direct and supervise Billing/Collection/Credentialing Department staff.
• Oversee staff training, development, and performance evaluations.
• Develop and implement strategies to maximize reimbursement and improve financial performance.
• Monitor key performance indicators and create regular reports for leadership.
• Ensure compliance with federal, state, and payer regulations.
• Ensure that the Federal Guidelines, Section 330 of the Public Health Service Act, is followed in regard to billing and collections.
• Lead process improvement initiatives to increase efficiency and reduce denials.
• Collaborate with clinical and financial teams to resolve issues and improve patient experience.
• Maintain policies and procedures relevant to revenue cycle activities.
• Oversee and maintain EPM/EMR and other technology used for billing functionality, real-time eligibility services, clearing house and any other billing related systems.
• Partner with Director of Quality regarding payer incentive programs.
• Negotiate payer contracts to maximize time filing limitations and reimbursement rates.
• Establish policies and procedures to ensure accurate and timely practitioner credentialing and payer enrollment.
• Oversee all period-end and year-end closing transactions and reporting.
• Assist in the development of the annual budget for the billing department.
• Assist in the development of the cost structure for the charge and collection budget for all services.
• Establish policies for the self-pay and sliding fee population that meet standard requirements of Section 330 of the Public Health Service Act.
• Perform other tasks and duties as assigned by the supervisor.
  
  

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience: Bachelor’s Degree in Business Administration or related field preferred. Minimum of three to five years’ experience in the field of billing and collections. A Medical Coding Certification preferred.

Confidentiality: The employee is required to understand the privacy policies and procedures. Patient Health Information (PHI) is confidential, only the minimal amount of PHI necessary to accomplish the internal purpose is to be shared or released.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required, but do not encompass all potential job functions. Must be able to lift up to 25 lbs., bend, manage steps, push, pull, and squat. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.

• This position is contingent upon a successful background check, credit check, health requirements and drug test.
• For more information about Centerpoint Health visit www.centerpointhealth.org
  
  
  

Centerpoint Health is an equal opportunity employer and is committed to creating an inclusive environment for all employees.

Bloodborne Pathogens Exposure: Category II

Job Type: Full-Time

Benefits:

Employee health insurance

Employee assistance program

Paid time off

Referral program

Retirement plan

Schedule:

Day shift

Monday to Friday

Work Location: Hybrid