Job Description
Job Description
JOB SUMMARY :
The Director of Billing and Credentialing will lead and manage the full scope of billing, collections and credentialing operations to ensure efficient and compliant submission of claims, accurate payment collection, and adherence to regulatory standards. This pivotal leadership role involves driving strategic improvements in patient billing processes, managing third-party billing, overseeing denials management, and ensuring contract compliance. The Director will collaborate with internal departments to enhance revenue cycle performance, leveraging both analytical insights and operational expertise.
QUALIFICATIONS / EDUCATION :
- Bachelor’s degree in business administration, Health Care Administration, or a related field is preferred,
- A minimum of 5 years of experience in healthcare revenue cycle management, including physician and hospital billing.
- At least 2 years of management or supervisory experience required.
CERTIFICATIONS / LICENSES :
NCCT CertificationCPC Certification - AAPC - RequiredCRC Certification - AAPC - PreferredCDEO Certification - AAPC - PreferredABILITIES / SKILLS :
In-depth knowledge of healthcare revenue cycle management, including patient billing, collections, denials management, and contract compliance.Proven leadership and supervisory skills with a focus on staff development.Excellent organizational, time management, and problem-solving abilities.Strong analytical skills with the ability to use data for decision-making and process improvements.Exceptional communication and customer service skills, with the ability to collaborate effectively across departments and external stakeholders.Ability to manage multiple priorities in a fast-paced, high-pressure environment.Proficiency with Microsoft Office Suite and healthcare billing software.Demonstrate ability to plan and organize projects.Able to always respect and maintain patient confidentiality.Must be dependable and conduct him / herself in a professional manner.Must be able to follow policies and procedures.SUPERVISORY RESPONSIBILITIES :
Directly supervises all the employees within the billing department.Carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws.Responsibilities include interviewing, hiring, training, counseling, and evaluating employees; planning, assigning, and directing work.Provide reports to management as needed.ESSENTIAL DUTIES / RESPONSIBILITIES :
Lead the billing, collections and credentialing team, providing oversight and development for staff, including hiring, training, and performance management.Manage end-to-end patient billing and collections, including third-party billing, denial management, charge master maintenance, and contract compliance.Ensure accurate, efficient generation and submission of claims, adhering to regulatory guidelines and payer policies.Oversee regular billing audits and clinical documentation reviews to ensure compliance and identify areas for process improvement.Collaborate with hospital and clinic departments to enhance revenue cycle metrics and overall financial performance.Manage and optimize billing systems and software, ensuring up-to-date and efficient operations.Utilize billing data to derive actionable insights for process optimization and resource management.Stay informed on industry trends, regulatory changes, and emerging billing technologies to keep department operations current and compliant.Prepare and manage the department’s budget, balancing cost control with efficiency improvements.Continuously seek opportunities to enhance productivity and improve service delivery.Maintain a safe and compliant work environment.Performs other duties as assigned by management.