Director Hospital Billing (remote/hybrid)

Hospital Billing Operations

• Lead and oversee hospital billing operations across the Presbyterian Delivery System, including Home Health and Hospice services.

• Direct all billing activities to ensure timely and accurate claim submission and reimbursement.

• Establish operational goals, service standards, and productivity expectations.

• Monitor performance and implement corrective action plans to address operational challenges.

• Ensure consistency of billing practices across all facilities and service lines.

Accounts Receivable & Reimbursement Performance

• Oversee third-party insurance billing and collections activities.

• Lead denial management and appeals strategies to optimize reimbursement.

• Monitor accounts receivable performance and implement strategies to improve cash collections.

• Reduce revenue leakage through effective billing controls, denial prevention efforts, and reimbursement optimization.

• Partner with payer contracting and finance teams to address reimbursement challenges and trends.

Financial Performance & Revenue Optimization

• Develop and monitor key performance indicators including:

  • Clean claim rate

  • Denial rate

  • Days in Accounts Receivable

  • Cash collections

  • Net collection rate

  • Aged receivables

  • Credit balance performance

• Drive operational improvements that enhance financial performance and support organizational goals.

• Develop strategies to maximize reimbursement while maintaining compliance.

Patient Financial Experience

• Promote a customer-focused approach to billing and collections.

• Partner with Revenue Cycle and Patient Experience leaders to improve patient financial communications and processes.

• Support financial assistance programs and patient-friendly billing practices.

• Balance collection performance with Presbyterian's commitment to service excellence.

Compliance, Audit & Risk Management

• Ensure compliance with Medicare, Medicaid, commercial payer requirements, and regulatory standards.

• Maintain billing integrity through strong internal controls and auditing processes.

• Implement safeguards around cash handling, payment posting, refunds, and credit balances.

• Support audit requests and compliance initiatives.

Process Improvement & Technology Optimization

• Lead automation and workflow redesign initiatives to improve efficiency and reduce manual work.

• Evaluate system enhancement opportunities and partner with IT teams to optimize billing technology.

• Continuously assess operational processes and implement best practices.

• Leverage analytics and benchmarking data to drive operational improvements.

Leadership & Team Development

• Lead, mentor, and develop Hospital Billing managers and staff.

• Foster a culture focused on accountability, customer service, continuous improvement, and employee engagement.

• Establish performance expectations and support professional development.

• Build organizational capability through succession planning and talent development initiatives.

Success Measures

Within the first 12-24 months, the Director will be expected to:

• Improve hospital billing performance across key reimbursement and AR metrics.

• Reduce claim denials and improve first-pass payment rates.

• Accelerate cash collections and reduce aged receivables.

• Enhance billing productivity through workflow optimization and automation.

• Strengthen billing compliance and audit readiness.

• Improve collaboration with operational, finance, and revenue cycle partners.

• Enhance the patient financial experience through improved billing practices and communication.

• Build a high-performing billing organization focused on accountability and operational excellence.

Required

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field, or equivalent work experience.

• 7+ years of progressive healthcare revenue cycle experience.

• 5+ years of leadership experience in hospital billing, patient financial services, or revenue cycle operations.

• Strong knowledge of:

  • Hospital billing operations

  • Medicare and Medicaid reimbursement

  • Commercial payer billing requirements

  • Denial management

  • Accounts receivable management

  • Revenue cycle performance metrics

• Experience leading large teams and operational improvement initiatives.