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.
Bachelor’s degree in Accounting, Finance, Healthcare Administration, or a related field required .
Minimum 7–10 years of healthcare or human services billing experience, including at least 3–5 years in a leadership position overseeing Medicaid billing operations.
Demonstrated experience managing billing operations using Millin or comparable Medicaid billing and revenue cycle platforms.
Advanced Excel skills experience required (e.g., VLookup, Pivot Table).
Strong experience developing and monitoring billing key performance indicators (KPIs), operational dashboards, and performance metrics.
Advanced knowledge of Medicaid billing regulations, claim submission protocols, rate structures, and payer requirements.
Proven ability to analyze billing data to identify revenue unaccounted loss of income due to underbilling, unbilled, errors, denial trends, and process improvement opportunities.
Strong analytical, leadership, and communication skills with the ability to translate complex billing data into actionable insights.
Experience implementing workflow improvements and automation within billing or revenue cycle processes.
Experience managing billing operations in a human services, behavioral health, or nonprofit environment preferred.
Demonstrated ability to train, mentor, and develop billing staff while promoting accountability and performance management.
Familiarity with Medicaid audits, regulatory reporting, and compliance oversight.
Benefits
At HeartShare we offer a comprehensive benefit package based on full-time/part-time status. You can expect:
Rewarding Work in a team environment.
Paid vacation, sick, personal days, and holidays.
403(B) retirement plans with employer contribution.
Health, dental, vision and life insurance.
Employee Assistance Program (EAP).
Flexible spending account (Dependent Care, Medical, Parking, and Transit).
Employee Appreciation Programs and Events.
Tuition Assistance Program.
Professional Development opportunities.
Wellhub Discount
Verizon Wireless Discount.
BJs Membership discount.
Discounts on Broadway tickets, movie tickets, theme parks, sporting events, gift certificates & more
HeartShare is an Equal Opportunity Employer (EOE). If you need to request accommodation during the recruiting process, please reach out to [email protected].
About Heartshare
Who WE ARE:
For over 150 years, Heartshare has been dedicated to championing and empowering New Yorkers society has too often overlooked and underestimated.
To learn more about HeartShare, please visit our website at or Follow us on Twitter LinkedIn YouTube Instagram Facebook
HeartShare Human Services of New York | Homepage
HeartShare Human Services of New York nurtures and empowers children and adults with intellectual and developmental disabilities.
Recommended Jobs
Professor of Practice in Art - Glass and 3D Tech
Professor of Practice in Art (Glass and 3D Tech) Start The Department of Art at Hartwick College invites applications for a full-time (75% teaching/25% tech work), two-year renewable appointment …
Manager, Analytics
Company description Zenith is one of Publicis Groupe's largest media agencies, spanning 95 markets globally with US offices in New York, Burbank, Chicago, Atlanta and Detroit. For more than 30 …
Operations Manager of Public Safety
Boston Medical Center (BMC) is more than a hospital. It´s a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest …
Senior Product Manager
Summary: Are you looking for an opportunity to build products that are changing the way we audit? The Senior Product Manager, Audit role leads the delivery of end-to-end product experiences …
Job Opportunity: Customer Support Specialist
Customer Support Specialist We have a great opportunity for a Customer Support Specialist to join our esteemed client in Cold Spring. As a vital part of our team, you will play a crucial function …
Executive Chef
Who We're Looking For... We are seeking an Executive Chef to take the reins of a high-energy, high-volume kitchen in New York City. This is a leadership role for a grounded, disciplined operator w…
Senior Sales Development Representative (SDR)
Path to AE • High-Impact Role • Healthcare Focus (Preferred) What We’re Looking For: Are you an experienced SDR/BDR who thrives on owning the top of the funnel, engaging senior decision-makers, …
Personal Trainer
The Certified Personal Trainers is the expert on health and fitness in the health club facility. They provide structured exercise prescription to clients with a variety of health and wellness goals. T…
Associate - Business Selection & Conflicts (BSC) - Global Corporate & Investment Banking (GCIB)
Bank of America () is one of the world's largest financial institutions, serving individual consumers, small businesses and large corporations with a full range of banking, investing, asset man…
Securities Quantitative Analytics Associate (Req. #001537)
At Wells Fargo, we want to satisfy our customers' financial needs and help them succeed financially. We're looking for talented people who will put our customers at the center of everything we do. H…