Director of Billing

The Director of Billing at HeartShare Human Services is responsible for leading and optimizing all aspects of predominantly Medicaid billing and overall revenue cycle performance across the organization ensuring timely and accurate claim submission maximizing reimbursement and maintaining compliance with all federal and state Medicaid regulations. This role oversees a data-driven billing operation leveraging analytics key performance indicators (KPIs) and system reporting to monitor productivity denial trends reimbursement rates and accounts receivable performance while driving continuous improvement through the use of technology including the Millin billing platform and implementation of best practices that enhance efficiency accuracy and financial outcomes. The Director partners closely with Fiscal Program Operations and Compliance teams to ensure billing integrity strengthen internal controls and support strategic decision-making related to revenue generation and regulatory compliance.

Primary Responsibilities and Essential Functions of Position:

Revenue Cycle Oversight

• Lead and manage the full Medicaid revenue cycle including claim submission rebilling payment posting denial management and accounts receivable reconciliation.
• Ensure timely claim submission and reimbursement optimization across all Medicaid-funded programs and other non-Medicaid programs (e.g. private pay ISS).
• Monitor aging accounts receivable and implement strategies to maintain optimal collection timelines.

Data Analytics and KPI Management

• Develop and monitor KPIs for billing operations including:
• Clean claim rate
• Days in accounts receivable
• Denial rates and root cause trends
• Claims submission timeliness
• Reimbursement cycle times
• Billing productivity metrics
• Utilize the Millin system reporting and data analytics tools to analyze billing performance and identify opportunities for revenue improvement.
• Produce regular billing analytics reports and dashboards for Fiscal leadership highlighting operational trends revenue performance and risk areas.

Team Leadership and Operational Management

• Lead mentor and supervise the billing team to ensure high performance accuracy and accountability.
• Establish performance expectations and productivity metrics for billing staff.
• Support professional development and cross-training to strengthen team capacity and operational resilience.

Compliance and Regulatory Oversight

• Ensure compliance with all Medicaid regulations billing policies and payer requirements.
• Oversee internal billing audits and coordinate preparation for external Medicaid or regulatory audits.
• Maintain up-to-date knowledge of Medicaid regulatory changes and reimbursement guidelines.

Process Improvement and Systems Optimization

• Evaluate billing workflows and implement process improvements to reduce errors increase automation and improve reimbursement turnaround.
• Collaborate with IT and Fiscal to optimize use of the Millin billing system including reporting functionality and workflow configuration.
• Identify opportunities for system enhancements data integrity improvements and operational efficiencies.

Cross-Functional Collaboration

• Partner with program leadership clinical teams and fiscal staff to resolve billing issues and strengthen documentation processes that support compliant billing.
• Serve as the primary liaison with Medicaid representatives and external partners related to billing and reimbursement matters.