Director of Operations (Medical Billing)

Director of Operations

Multi-Specialty Medical Billing (ED, Anesthesia, Hospitalist, ICU)

Location: El Segundo, California | On-Site | Full-Time, Exempt

Position Summary

We are a high-volume, multi-specialty medical billing and revenue cycle management (RCM) organization that bills for more than 1,250,000 patient visits annually across Emergency Department (ED), anesthesia, hospitalist, and ICU service lines. We are seeking a Director of Operations who operates as a hands-on problem-solver and operational investigator — someone who actively digs into billing workflows, uncovers revenue leakage, defines solutions, and drives those solutions to completion. This is not a role focused on managing people; it is a role focused on identifying what is broken, defining how to fix it, holding the right people accountable, and confirming the fix holds. This role is based on-site in El Segundo, California, and reports to executive leadership. This role will have the support of a team of analysts.

Key Responsibilities

Revenue Leakage Detection & Problem Identification

• Proactively audit billing operations across ED, anesthesia, hospitalist, and ICU service lines to identify revenue leakage including missed charges, under-coded claims, denial patterns, aging AR, and avoidable rework.
• Investigate root causes of operational failures: trace problems upstream through charge capture, coding, claim submission, denial management, payment posting, and AR follow-up to find where breakdowns originate.
• Quantify the financial impact of identified problems in dollars, volume, and trend and prioritize remediation by business impact.
• Surface problems before they escalate: monitor leading indicators across the revenue cycle and flag emerging issues to leadership with context and recommended action.

Solution Research & Definition

• For each identified problem, research the optimal solution: benchmark against industry best practices, evaluate workflow and technology options, consult with subject matter experts (coding, billing, IT, compliance), and define a clear, actionable remediation plan.
• Translate complex operational problems into well-scoped project definitions with clear success criteria, milestones, owners, and timelines.
• Evaluate technology, automation (including RPA and AI-assisted billing tools), and workflow changes as potential solutions; build the business case for recommended investments.
• Collaborate cross-functionally with Coding, Client Services, IT, Compliance, Finance, and Human Resources to ensure solutions are feasible and well-supported.

Project Tracking & Accountability

• Own the tracking of all active problems and remediation projects from identification through confirmed resolution — maintaining a living log of issues, assigned owners, status, and outcomes.
• Hold task owners accountable for commitments: follow up on open items, escalate stalled work, remove blockers, and ensure nothing falls through the cracks.
• Define and enforce standard operating procedures (SOPs) and service level agreements (SLAs) across billing functions; monitor adherence and escalate deviations.
• Confirm that implemented solutions actually work: validate results with data, monitor for recurrence, and close out projects only when the metrics confirm the problem is resolved.

Analysis & Reporting

• Conduct deep-dive analyses alongside the analyst team to understand trends, anomalies, and financial impact; translate findings into clear, actionable recommendations presented to executive leadership and clients.
• Produce regular and ad-hoc reporting on problem status, project progress, and remediation outcomes making the health of operations visible and measurable at all times.

Process Improvement

• Lead continuous process improvement across the revenue cycle, designing workflows, controls, and guardrails that reduce the frequency and severity of errors going forward, not just fixing what is broken today.
• Work with Director of Compliance to ensure compliance with HIPAA, CMS, and payer-specific billing guidelines; partner with compliance and audit on corrective action plans when issues are identified.

Required Qualifications

• 5 years of hands-on revenue cycle / medical billing operations experience, with a demonstrated track record of identifying and resolving operational problems and revenue leakage.
• Familiarity with coding and billing, specifically professional fee billing, E/M leveling, critical care, observation, and high-acuity procedure capture. ED experience is preferred.
• Experience in a high-volume billing environment (500,000 annual encounters; 1,000,000 preferred); able to analyze operations at scale and distinguish signal from noise.
• Strong command of revenue cycle KPIs and operational analytics: clean claim rate, denial rate, days in AR, net collection rate, cost-to-collect, cash yield, and productivity metrics, and the ability to use these to pinpoint where money is being lost.
• Advanced skills with Claude, Excel and modern BI/reporting tools (Power BI, Tableau, Looker, or equivalent); SQL literacy is a plus.
• Experience defining, documenting, and implementing SOPs and operational controls that stick, with the discipline to track compliance and hold others to standards.
• Working knowledge of major billing/EHR/clearinghouse platforms commonly used in ED and hospital-based specialty billing.
• Excellent written and verbal communication skills; able to present problem findings, root causes, and recommended solutions clearly to executives, clients, and operational teams.
• Bachelor’s degree required; Master’s (MBA, MHA, MPH) preferred.

Preferred Qualifications

• Understanding of HIPAA, CMS guidelines, payer policies, and compliance best practices.
• Experience billing for multiple hospital-based specialties: anesthesia, hospitalist, and ICU in addition to ED.
• Professional certifications such as CPC, CPC-H/COC, CEDC, CEMC, CRCR, CHFP, or Lean/Six Sigma (Green Belt or higher).
• Experience evaluating and deploying automation, RPA, or AI-assisted coding/billing tools in a revenue cycle environment.
• Familiarity with offshore or BPO billing operations, including the ability to work effectively across time zones with operations teams in the Philippines.

Work Environment & Travel

• On-site position in El Segundo, CA. This is not a remote role.
• Rare domestic travel to client sites and/or international travel to the Philippines operations center may be required

Compensation & Benefits

Competitive base salary and bonuses, commensurate with experience, specialty expertise, and scope of prior duties.

Comprehensive benefits package includes medical, dental, vision, 401(k), paid time off, and professional development support.

Equal Opportunity Statement

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic under applicable federal, state, or local law.

How to Apply

Qualified candidates are invited to submit a resume and a brief cover letter outlining relevant experience. Applications are reviewed on a rolling basis.