Billing Director

Job Overview

We are seeking a highly skilled and strategic Billing Director to lead our billing operations. Serve as a working supervisor for the in-house billing team, providing day-to-day direction and support to approximately 4-5 team members.

Job Function:

• Serve as a working supervisor for the in-house billing team, providing day-to-day direction and support to approximately 4-5 team members.
• Coordinate daily billing workflow, priorities, and work assignments in collaboration with the Laboratory Director.
• Manage and provide oversight for the billing team in claim submission, payment posting, insurance verification, accounts receivable follow-up, denials and rejections, appeals, collections, client invoicing, patient balances, credentialing, and related billing activities.
• Support accurate and timely billing of professional laboratory claims, including federal / commercial payers and advantage plans.
• Monitor remittances for payment trends, denials, unresolved balances, processing delays, and other recurring issues assisting with research and resolution.
• Serve as the first line of support for routine workflow, attendance, and performance concerns and escalate significant issues to the Laboratory Director.
• Coach, train, and retrain team members with support and guidance from the Laboratory Director.
• Address team performance and workflow issues promptly and professionally.
• Participate in interviewing and selection of new billing team members.
• Communicate professionally with physician offices, healthcare facilities, insurance companies, federal and commercial payers, clients, vendors, patients, and internal departments as needed.
• Assist and identify billing and remittance issues developing solutions and process improvements.
• Maintain and provide billing records and reports and assist with development and monitoring of departmental key performance indicators as implemented.
• Promote accountability, teamwork, respectful communication, and consistent follow-through within the department.
• Other duties as assigned.

Working Conditions: Primarily an office and computer-based position with a high-volume workload. Occasional remote work may be available based on operational needs and management approval. Travel to company or remote laboratory locations may be required, generally less than 10%.

Education/Experience:

• Demonstrated medical billing experience required
• Clinical or reference laboratory billing experience strongly preferred but training will be made available for qualified candidates.
• Experience with Medicare and Medicaid billing, including both Part A and Part B claims.
• Working knowledge of commercial insurance billing and professional claims.
• Previous supervisory, team-lead, or demonstrated leadership experience strongly preferred.
• Experience with accounts receivable, denials, payment posting, insurance verification, collections, claims follow-up, payer portals, and electronic billing systems preferred.
• Familiarity with CPT, ICD-10, HCPCS, medical necessity, and medical terminology.
• Working knowledge of HL7 and other electronic file type transmitting claims and related data.

Education/Experience:

• Demonstrated medical billing experience required
• Clinical or reference laboratory billing experience strongly preferred but training will be made available for qualified candidates.
• Experience with Medicare and Medicaid billing, including both Part A and Part B claims.
• Working knowledge of commercial insurance billing and professional claims.
• Previous supervisory, team-lead, or demonstrated leadership experience strongly preferred.
• Experience with accounts receivable, denials, payment posting, insurance verification, collections, claims follow-up, payer portals, and electronic billing systems preferred.
• Familiarity with CPT, ICD-10, HCPCS, medical necessity, and medical terminology.
• Working knowledge of HL7 and other electronic file type transmitting claims and related data.

Job Requirements:

• Strong written and verbal communication skills with the ability to provide clear direction and constructive feedback.
• Exceptional attention to detail and ability to maintain accuracy while managing competing priorities.
• Strong analytical, organizational, and problem-solving skills with consistent follow-through.
• Ability to work both independently and collaboratively and to recognize when an issue should be escalated.
• Professional judgment, discretion, emotional maturity, and the ability to remain calm when resolving difficult billing or customer concerns.
• Strong computer skills and ability to learn new billing systems, electronic health information systems, payer requirements, and workflows.
• Ability to protect confidential information and maintain professional relationships with employees, clients, patients, payers, and business partners.
• Completion of HIPAA, compliance, privacy/security, and role-specific training within required timeframes.
• Consent to background screening, drug screening, and other employment requirements in accordance with company policy and applicable law.

Reports to: Laboratory Director; for complaints or concerns employees may also contact Human Resources.

Physical Requirements:

• Must be able to perform prolonged computer and desk-based work and use standard office equipment.
• Must possess sight/hearing senses or use prosthetics that will enable these senses to function adequately so that job requirements are met.
• Must be able to communicate effectively by telephone, electronic systems, and in person.
• Must be able to cope with the mental and emotional demands of the position and function effectively in a variety of work environments.
• Must be able to engage professionally with customers and others who may at times be upset or difficult.

Confidentiality and Compliance: Employees must maintain strict confidentiality of patient, insurance, financial, and business information in accordance with HIPAA, company policies, contractual obligations, and applicable federal, state, and local requirements. Violation may result in disciplinary action up to termination. Employees must comply with applicable privacy, security, billing, fraud-and-abuse, and company compliance requirements.

Training and Development: New hires will receive orientation on company policies, compliance requirements, and role-specific skills. Ongoing training will be provided annually or as required by law, payer requirements, or company policy.

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $56,194 - $82,524