Director of Billing

Job Description

Job Description

Position Summary

The Director of Billing oversees the daily operations and performance of Brennan Behavior Group’s billing department. This position leads a team of four to six billing employees and ensures claims are submitted accurately and timely, accounts receivable is actively managed, denials are resolved, and billing procedures are consistently followed.

The Director provides leadership, training, accountability, and support to the billing team while maintaining a strong understanding of daily billing operations. The ideal candidate is organized, detail-oriented, analytical, comfortable working with insurance companies, and able to identify problems and implement effective solutions.

The Director works independently and keeps the CEO informed of department performance, concerns, opportunities, and recommendations for improvement.

Essential Duties and Responsibilities

Team Leadership & Accountability

• Lead and oversee a team of four to six billing employees.
• Assign and monitor daily responsibilities and workload.
• Establish expectations for productivity, accuracy, timeliness, and follow-through.
• Monitor team performance and address concerns as needed.
• Provide coaching, guidance, and training.
• Assist employees with complex billing and insurance issues.
• Monitor attendance, timeliness, productivity, and completion of assigned responsibilities.
• Promote accountability while maintaining a professional and supportive work environment.
• Identify training needs and provide ongoing education.
• Escalate significant performance concerns to the CEO.

Billing Operations

• Oversee creation, submission, and monitoring of insurance claims.
• Ensure claims are accurate and submitted within payer filing deadlines.
• Review billing activity for accuracy and completeness.
• Monitor claim rejections and ensure corrections are completed promptly.
• Ensure required modifiers, documentation, authorizations, and insurance information are included.
• Monitor electronic claims and clearinghouse activity.
• Ensure staff follow established billing procedures and payer requirements.
• Assist with billing and claim follow-up when necessary.

Accounts Receivable & Collections

• Monitor outstanding claims and accounts receivable.
• Review aging reports and prioritize claim follow-up.
• Ensure aging claims are consistently worked within timely filing requirements.
• Monitor high-dollar and aging claims.
• Identify trends contributing to outstanding balances.
• Develop strategies to reduce aging AR.
• Track unresolved claims and ensure appropriate follow-up.
• Escalate significant or unresolved AR concerns to the CEO.

Denials & Appeals

• Monitor claim denials and identify recurring trends.
• Ensure denied and rejected claims are researched and corrected promptly.
• Coordinate collection of required medical records and documentation.
• Submit corrected claims, reconsiderations, and appeals as appropriate.
• Track appeals and ensure timely follow-up.
• Identify opportunities to prevent recurring denials.
• Educate billing staff on common billing errors and denial prevention.

Insurance & Authorizations

• Monitor insurance eligibility and authorization-related billing concerns.
• Assist with resolving authorization issues affecting claims or payment.
• Communicate with insurance representatives regarding claim status, denials, authorizations, and payment issues.
• Maintain accurate documentation of insurance communications.
• Track and address time-sensitive insurance requirements.

Reporting & Performance Management

• Monitor and report billing department KPIs.
• Maintain accurate billing reports and tracking spreadsheets.
• Provide regular performance updates to the CEO.
• Monitor trends in claims submitted, rejected and denied claims, aging AR, payments, adjustments, outstanding claims, authorizations, and insurance verification.
• Identify operational concerns and recommend solutions.
• Maintain accurate Google Sheets, Google Drive, and other electronic billing records.

Process Improvement

• Evaluate billing processes and identify opportunities for improvement.
• Develop and implement standardized billing procedures.
• Improve efficiency, reduce errors, and increase collections.
• Implement improvements to billing workflows.
• Assist with billing audits and quality-control reviews.
• Ensure staff consistently follow established processes.

Communication & Collaboration

• Communicate professionally with insurance companies, clients, and internal staff.
• Collaborate with clinical, scheduling, administrative, and leadership teams to resolve billing concerns.
• Communicate documentation or authorization concerns to appropriate team members.
• Maintain confidentiality when handling protected health information.
• Escalate significant billing concerns to the CEO in a timely manner.

Qualifications

Required

• High school diploma or equivalent.
• Minimum of 10 years of experience in medical billing, healthcare billing, revenue cycle management, or a related field.
• Experience supervising, leading, or training billing staff.
• Experience with insurance claims, denials, and accounts receivable.
• Experience with Medicaid and commercial insurance.
• Strong computer skills, including Google Workspace.
• Strong organizational and time-management skills.
• Excellent attention to detail.
• Ability to analyze billing information and identify discrepancies.
• Strong written and verbal communication skills.
• Ability to maintain confidentiality and comply with HIPAA requirements.
• Ability to work independently and manage multiple priorities.

Preferred

• Experience with ABA therapy or behavioral healthcare billing.
• Experience with Louisiana Medicaid.
• Experience with commercial insurance payers.
• Experience with insurance authorizations.
• Experience with clearinghouses and electronic claim submission.
• Experience with EHR and medical billing systems.
• Previous billing team management experience.
• Experience with AR cleanup, denials, and appeals.

Knowledge, Skills, and Abilities

• Strong knowledge of healthcare billing processes.
• Understanding of insurance claims and payer requirements.
• Ability to analyze aging AR and prioritize claim follow-up.
• Ability to research and resolve complex billing issues.
• Strong understanding of denial management and appeals.
• Strong leadership, coaching, and accountability skills.
• Strong problem-solving and critical-thinking skills.
• Ability to identify trends and develop solutions.
• Strong attention to detail and accuracy.
• Ability to manage deadlines and time-sensitive billing requirements.
• Effective communication with employees, leadership, insurance companies, and clients.
• Ability to adapt to changing priorities and processes.

Key Performance Expectations

The Director of Billing is expected to maintain and improve department performance in the following areas:

• Timely and accurate claim submission
• Claim rejection and denial management
• AR aging and timely follow-up
• Appeal completion
• Payment posting accuracy
• Authorization tracking
• Insurance verification
• Billing team productivity and accountability
• Reduction of preventable billing errors
• Consistent adherence to billing procedures

Work Environment

This position is performed in a professional office environment and requires frequent use of computers, billing software, electronic health records, clearinghouses, Google Workspace, and other electronic systems. The position requires regular communication with billing staff, insurance representatives, leadership, and other BBG employees.

Success in the Role

Success is demonstrated by a billing department that is organized, accountable, and consistently meeting established performance expectations. The Director effectively leads the four-to-six-person billing team, ensures claims are submitted accurately and timely, actively manages AR and denials, addresses performance concerns, identifies billing issues, improves processes, and communicates department performance and concerns to the CEO.