SUMMARY:

The Billing Director, reporting to the Vice President of Finance, will be responsible for ensuring that all Revenue Cycle Manager (RCM) partners adhere to contract agreements and billing compliance related to insurance, Medicaid, and Medicare. This role requires strong analytical skills, attention to detail, and a robust understanding of the healthcare billing process within the behavioral health sector.

SKILLS/KNOWLEDGE/ABILITIES:

1. Knowledge of Medicare, Medicaid, and commercial insurance billing requirements for behavioral health services is essential.
2. Proven experience in managing a team and driving performance in a fast-paced environment.
3. Strong analytical skills with the ability to interpret complex data and generate actionable insights. 4. Excellent interpersonal and communication skills, both verbal and written, with a customer-focused mindset and an emphasis on team collaboration.

EDUCATION AND EXPERIENCE:

1. Bachelor’s degree in Health Administration, Finance, Business Administration, Accounting, or related field; Master’s degree preferred.
2. 10+ years of healthcare billing or revenue cycle management, with a focus on behavioral health strongly preferred.
3. Experience using billing systems, automated accounting systems, and integrations

Provide training and support to billing staff to enhance their knowledge of billing practices, contracts, and compliance requirements.

• Stay abreast of changes in healthcare regulations, payer policies, and industry best practices related to behavioral health billing.
• Develop and maintain strong relationships with RCM partners, in particular the State of New Mexico, ensuring alignment with the Center’s goals and objectives, while actively collaborating across teams

• Direct the Santa Fe Recovery Center’s billing operations by monitoring the day-to-day flow of recorded sessions, coding, charge entry, claims filing, payor accounts receivable follow-up, denials, client collections, bad debt monitoring, and troubleshooting issues.
• Oversee and manage the billing processes for insurance, Medicaid, and Medicare claims to ensure compliance with all regulations and contract agreements.
• Ensure timely submission of bills and follow-up on unpaid or denied claims, engaging in discussions with payers as needed to resolve issues.
• Conduct regular audits and compliance checks to maintain adherence to policies, procedures, and regulatory requirements.
• Collaborate with clinical and administrative staff to ensure accurate documentation and coding of services provided, enhancing interdisciplinary communication.
• Monitor and analyze billing metrics and revenue cycle performance, identifying trends and areas for improvement.
• Address and resolve any discrepancies or billing disputes swiftly and effectively, fostering open dialogue with stakeholders.
• Oversee the credentialing process for healthcare providers, ensuring compliance with industry standards and regulations.

Provide training and support to billing staff to enhance their knowledge of billing practices, contracts, and compliance requirements.

• Stay abreast of changes in healthcare regulations, payer policies, and industry best practices related to behavioral health billing.
• Develop and maintain strong relationships with RCM partners, in particular the State of New Mexico, ensuring alignment with the Center’s goals and objectives, while actively collaborating across teams.