Program and Policy Finance Expert - Program Director-Professional Billing

Salary: $100 per hour

SUMMARY

We are seeking to hire a Program Director for Professional Medical Biling responsible for leading and managing the professional billing operations for the organization to ensure accurate, compliant, and timely billing processes.

This role requires a strong understanding of healthcare reimbursement, payer rules, and revenue cycle management best practices.

The director will oversee staff, drive performance improvement initiatives, and collaborate with senior leadership to optimize revenue while maintaining regulatory compliance and exceptional patient financial experiences.

ESSENTIAL FUNCTIONS


* Assists in the formulation, implementation and interpretation of revenue systems, professional billing programs and administrative policies and procedures; supervises the preparation of instructions for implementation.


* Has responsibility for the coordination, development, and evaluation of administrative and support services to ensure successful implementation of policies and procedures governing revenue systems and programs or initiatives.


* Coordinates the development and maintenance of effective systems for budgetary controls and the projection of revenue or professional services initiatives, policies and programs.


* Initiates, plans and supervises the conduct of administrative programs creation and set-up for professional revenue operations and procedures or professional services policies and initiatives, and the preparation of reports; recommends new and revised policies and procedures in order to effect maximum operational efficiency, improve services, and reduce administrative costs.


* Serves as subject matter expert for implementation and maintenance of revenue systems and programs with departmental administration and facilities, state and federal agencies, other County departments, and private computer systems firms.


* Provides administrative direction for a major operational segment of the health services programs.


* Directs the review and study of other health care systems and facilities in order to evaluate new management techniques, systems and practices for use in the department.


* May act for the Chief, Revenue Cycle Management in the latter's absence.

 

JOB QUALIFICATIONS


* Bachelor’s degree in healthcare administration, business, or related field required; master’s degree preferred.


* Minimum of 7–10 years of progressive healthcare billing or revenue cycle experience, with at least 3 years in a leadership role.


* Strong knowledge of hospital and physician billing, payer regulations, and compliance requirements.


* Demonstrated success leading teams, driving process improvement, and achieving key revenue cycle KPIs.


* Proficiency in EHR and billing software, with advanced Microsoft Excel and reporting skills.


* Certification such as CPC, CCS, CRCR, or CRCP preferred.

Certificates/Licenses/Clearances


* Successfully clear t...