What are the responsibilities and job description for the Director, Medical Billing position at OptySuite?
We’re seeking a highly experienced Director of Medical Billing to lead and optimize the full revenue cycle operations for multiple clients. This role requires a strategic thinker who is equally comfortable rolling up their sleeves to solve complex billing challenges. You’ll oversee credentialing, payment posting, onboarding new clients, system implementations, and direct communication with practices and providers. If you thrive in a fast-paced environment and know how to keep a revenue cycle running smoothly, this is your arena.
Key Responsibilities
Revenue Cycle Management
- Direct all aspects of the billing lifecycle, including credentialing, claim submission, payment posting, denial management, and collections.
- Ensure timely, accurate processing to maximize revenue across multiple clients.
Compliance & Auditing
- Maintain strict adherence to HIPAA, Medicare/Medicaid guidelines, and payer contract requirements.
- Conduct internal audits and implement corrective actions as needed.
Team Leadership
- Supervise, train, and mentor billing staff to ensure high performance, accuracy, and accountability.
- Foster a collaborative, solutions-oriented team culture.
A/R Analysis & Reporting
- Monitor A/R aging and identify trends impacting cash flow.
- Prepare and present detailed financial reports, KPIs, and recommendations to senior leadership and clients.
Payer Relations
- Serve as the primary escalation point for complex claim issues and underpayments.
- Build and maintain strong relationships with insurance payers to expedite resolutions.
System Optimization
- Oversee billing software and practice management systems to ensure efficiency and accuracy.
- Lead new system implementations and workflow improvements.
Client Engagement
- Participate in onboarding new clients, ensuring smooth transitions and clear expectations.
- Conduct regular meetings with clients to review performance, address concerns, and strategize improvements.
Required Qualifications
- Education: Bachelor’s degree in healthcare administration, business, or related field preferred.
- Experience: Minimum of 10 years of progressive medical billing experience, including significant supervisory or management responsibilities.
- Knowledge: Strong understanding of ICD-10, CPT, HCPCS, payer rules, and reimbursement methodologies.
- Technical Skills: Proficiency with EHR/billing platforms (Epic, Athena, NextGen, etc.) and advanced Excel capabilities.
Core Competencies
- Strong analytical and critical thinking abilities.
- Excellent leadership, communication, and interpersonal skills.
- Ability to manage competing priorities, work under pressure, and meet deadlines.
- High attention to detail with a commitment to accuracy and compliance.
Benefits:
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person