7-10 years of progressive experience in healthcare billing, with 3-5 years in a managerial role
Proficiency with Epic systems, including configuration and reporting
Strong knowledge of Massachusetts healthcare billing regulations and payer requirements
Excellent communication skills and attention to detail
Results-driven with a commitment to quality assurance and exceptional customer service
Experience in quality improvement/change management and project management
Bachelor's degree in healthcare administration, business, finance, or a related field preferred
Responsibilities
Supervise and mentor the billing team, ensuring high standards of accuracy and productivity
Create a vision for C3 as a leading resource for efficient billing and credentialing
Facilitate collaboration with leaders across the MSO and Health Centers
Conduct regular performance reviews and address issues promptly
Establish and maintain user-friendly billing and collections policies and procedures
Identify and implement process improvements for revenue cycle operations
Oversee daily billing operations, ensuring timely and accurate claims processing
Benefits
Hybrid work model in Boston
Opportunity to lead a dynamic team in a mission-driven organization
Engagement in strategic initiatives that impact financial goals
Professional development opportunities in healthcare billing and management
Collaborative work environment with cross-functional teams
Full Job Description
Title: Director, Billing and Accounts Receivable Reports to: VP, Credentialing and Billing Classification: Director
Location: Boston (Hybrid)
Job description revision number and date: V2.0; 4.24.25
Job Summary:
This position provides leadership and oversight to the billing and accounts receivable activities for our FQHCs that are on our instance of Epic and/or in our Share Services model. The ideal candidate will lead and manage a team of billing and operational resources, ensuring compliance with state and federal guidelines, optimize accounts receivable performance, and provide strategic support to both C3 and our FQHCs financial goals. The position collaborates with the Revenue Integrity Director and Credentialing Manager particularly around claim form logic, denial management, and optimal Epic workflow and reporting. The Director of Billing and Accounts Receivable should have a background in FQHC billing requirements, proficiency in using Epic, and a solid understanding of healthcare billing regulations, particularly in Massachusetts.
Responsibilities:
Supervises and mentors the billing team, providing training and support to maintain high standards of accuracy and productivity
Helps create the vision for the C3 to be the go-to resource for an affordable and efficient MSO in Billing and Credentialing
Facilitates positive collaboration with other leaders within the MSO, across C3, and at the Health Centers
Conduct regular performance reviews and address performance issues promptly
Foster a collaborative and professional team environment
Remains current on billing codes, payer requirements, and policy changes
Establishes, updates, and maintains policies and procedures governing billing and collections, ensuring the documentation is always current, complete, and user-friendly
Identifies process and technology improvements to improve the effectiveness and efficiency of revenue cycle operations. Collaborates with internal and external constituents to execute improvements
Oversees all AR including insurance and self pay
Oversees daily billing operations for the FQHC(s), ensuring accurate and timely processing of claims
Monitors and analyzes billing processes to identify areas for improvement and implement solutions
Ensures daily reconciliation of claims transmitted to claims acceptance is completed in a timely manner
Manages accounts receivable, ensuring collections are optimized and follow-up processes are timely and efficient
Utilizes and creates Epic WQs to best manage and segment the assigned work to team members to ensure productivity standards are met and all AR is managed timely
Regularly completes denial management trending and root cause analysis to implement denial prevention strategies
Serves as the primary point of contact for EPIC-related billing processes and configurations
Ensures optimal utilization of the EPIC system to streamline workflows and enhance billing and AR efficiency
Collaborates with IT and EPIC support (CTC) teams to resolve technical issues and implement system updates
Follows ticket management processes and criteria when needing technical system support or updates
Prepares and presents regular reports on revenue cycle performance, billing metrics, key performance indicators (KPIs), and trends
Prepares month end results reporting packages
Define and meets/exceeds AR management and cash collections goals
Analyzes data to identify opportunities for revenue growth and process enhancements
Develops and implements strategies to reduce denials and improve collections
Ensures all billing activities comply with state and federal regulations, including those specific to FQHCs and Massachusetts healthcare laws
Maintains knowledge of Medicaid, Medicare, and commercial insurance policies applicable to FQHCs
Works closely with clinical, administrative, and finance teams to ensure alignment on billing/AR practices and revenue goals
Works closely with vendors and other third parties to facilitate timely and accurate data capture and collections
Represents the billing department in audits, meetings, and organizational planning sessions
Consistently provides service excellence to all patients, family members, visitors, volunteers, and co-workers in a manner that reflects C3's mission and core values
Other duties as assigned
Required Skills:
Proficiency with Epic systems, including configuration and reporting
A minimum of 7-10 years of progressive experience in healthcare billing, with at least 3-5 years in a managerial role
Strong knowledge of Massachusetts healthcare billing regulations and payer requirements
Strong leadership, excellent communication skills across stakeholders, attention to detail, and critical thinking skills
Results driven and outcome focused
Must be innovative, comfortable with ambiguity, well-organized, and committed to moving quickly and collaboratively in the context of a rapidly changing organization
Experience with quality improvement/change management and project management
Proficiency in Microsoft Office Suite
Must have a strong commitment to quality assurance and exceptional customer service
A strong commitment to the organization's mission
Desired Other Skills:
Certification in medical billing or coding (e.g., CRCR, CPC, CPB) is a plus
Epic certification in charge router, professional billing/Resolute, or other Epic EHR functionality
Familiarity with the MassHealth ACO program
Experience working in Federally Qualified Health Centers (FQHC)
Experience with anti-racism activities, and/or lived experience with racism is highly preferred
Qualifications:
Bachelor's degree in healthcare administration, business, finance, or a related field preferred
