Director of RCM - Solution Based Therapeutics

Location: Los Angeles, CA
Reports to: Chief Financial Officer (CFO)
Department: Finance/Billing
Employment Type: Full-Time

Position Overview:

The Director of Billing will be responsible for overseeing and managing the billing and collections functions within the facility. This role will ensure accurate billing procedures are followed, payments are processed in a timely manner, and compliance with healthcare regulations and insurance requirements is maintained. The Director will lead a team of billing specialists, develop best practices, and drive efficiency and profitability within the billing department.

Key Responsibilities:

• Leadership & Management:

  • Lead and supervise the billing team, providing guidance, mentorship, and performance evaluations.
  • Develop and implement billing policies and procedures to ensure timely, accurate, and compliant billing.
  • Monitor team productivity and performance metrics, identifying areas for improvement.

• Billing Operations:

  • Oversee daily billing activities including claim submissions, payment posting, and reconciliation.
  • Ensure accurate processing of billing for all services rendered, including private insurance, Medicare, Medicaid, and self-pay accounts.
  • Work closely with clinical and administrative teams to resolve discrepancies in patient documentation and billing.

• Compliance & Regulatory:

  • Ensure compliance with all federal, state, and local regulations related to healthcare billing (e.g., HIPAA, CMS guidelines).
  • Stay up to date on billing regulations, coding changes, and insurance updates, and communicate any changes to the team.

• Financial Reporting & Analysis:

  • Collaborate with the finance department to review accounts receivable reports and identify trends in billing, collections, and denials.
  • Prepare and present financial reports related to billing, collections, and payer reimbursements to executive leadership.
  • Analyze reimbursement rates and payer contracts to optimize revenue.

• Customer Relations:

  • Serve as the point of contact for escalated billing issues from patients, payers, and internal staff.
  • Work closely with insurance companies to resolve disputes and ensure timely payments.

Qualifications:

• Education:
  • Bachelor's degree in healthcare administration, business, finance, or a related field. A master's degree is a plus.
• Experience:
  • Minimum of 5 years of experience in healthcare billing, with at least 2 years in a leadership or management role. Experience in a rehabilitation or behavioral health setting is preferred.
• Skills:
  • Strong knowledge of billing systems, medical coding (CPT, ICD-10), and healthcare reimbursement processes.
  • Familiarity with insurance verification, claim submission, and denial management processes.
  • Excellent leadership, communication, and organizational skills.
  • Proficiency in billing software and electronic medical records (EMR) systems.
  • Analytical mindset with the ability to work with financial data and prepare reports.