Director of Billing

This role ensures timely and accurate billing, reimbursement optimization, regulatory compliance with NYSDOH and CMS requirements, and effective coordination with intake, clinical, authorization, and finance departments.

The Director of Billing plays a critical role in maintaining agency financial stability while supporting compliant patient care delivery.

The Director of Billing reports directly to the Chief Financial Officer (CFO), Administrator, or Executive Director, as designated.

Responsibilities:

Oversees all billing functions for CHHA services, including Medicare, Medicaid, Managed Care, Medicare Advantage, and commercial payers
Ensures accurate and timely submission of claims in compliance with NYSDOH, CMS, and payer-specific requirements
Monitors billing timeliness, denial rates, payment variances, and aging accounts receivable
Works collaboratively with finance to reconcile revenue, cash posting, and payer remittances
Directly supervises billing staff, medical records staff, and authorization personnel (as applicable)
Oversees training, performance management, and workflow efficiency within the billing department
Ensures compliance with: NYSDOH CHHA regulations, CMS Medicare Conditions of Participation, Medicaid billing and managed care requirements
Maintains readiness for NYSDOH and CMS audits and surveys
Ensures billing practices align with: OASIS completion
Physician orders
Plan of Care certification and recertification
Visit documentation standards
Participates in corrective action plans related to billing, documentation, or compliance findings
Works closely with Intake and Authorization teams to ensure services are authorized and billable
Clinical leadership to resolve documentation or order deficiencies
Quality Assurance to address audit findings and improve compliance
Identifies system or process gaps that impact billing accuracy or timeliness and implements solutions
Develops and reviews billing and revenue reports, including: Denials and rejections, Authorization issues, Days in A/R, Missed or delayed billing opportunities
Provides regular performance reports to executive leadership
Uses data to identify trends, risks, and opportunities for improvement
Ensures billing staff are trained and competent in current billing rules and payer requirements
Establishes clear workflows, accountability, and productivity expectations
Supports ongoing education related to regulatory changes and payer updates
Qualifications:

Bachelor’s degree in healthcare administration, business, finance, or related field preferred
Equivalent experience in CHHA billing may be considered
Minimum 5 years of healthcare billing experience, with at least 3 years in home health (CHHA) billing
Demonstrated experience with: Medicare home health billing
Medicaid and Managed Care billing in NYS
CHHA documentation and regulatory requirements
Prior supervisory or management experience required
Proficiency with home health billing systems (e.g., HCHB or similar)
Excellent analytical, organizational, and problem-solving skills
Strong communication and leadership abilities
Ability to work collaboratively across departments