Description:
Affinity Care MN is growing, and we are seeking an experienced, strategic billing leader to join us as our next Billing Director. The Billing Director provides strategic leadership and oversight of all billing operations, developing and implementing the billing policies, procedures, and systems that ensure accurate, timely, and compliant reimbursement across all programs. The Billing Director oversees claims submission, accounts receivable, payer relationships, provider credentialing, and billing staff supervision to support the organization's financial health and operational efficiency.
This role requires a strong understanding of healthcare and human services billing practices, excellent analytical skills, and the ability to balance regulatory compliance with operational efficiency. The Billing Director partners with executive leadership, providers, and payers to ensure accurate billing and optimal financial performance.
Billing Director Responsibilities
- Oversee all billing operations, including claims submission, reimbursement tracking, and account reconciliation across all programs.
- Own accounts receivable performance department-wide: monitor aging, resolve escalated denials, and set the strategy to keep AR current.
- Develop and implement billing policies, procedures, and internal controls, including innovative and AI-assisted billing solutions, to improve accuracy and efficiency.
- Build detailed billing and AR reports and present performance, revenue trends, and reimbursement risk to executive leadership.
- Lead, mentor, and hold accountable a billing team of three, including hiring, training, and performance management.
- Oversee provider credentialing, re-credentialing, enrollment, and revalidation activities to ensure compliance with payer requirements.
- Serve as the primary point of contact for payer audits and billing-related compliance reviews.
- Ensure billing practices comply with Medicaid, insurance, MCO, and applicable state and federal regulations, including MNITS requirements.
- Partner with Finance and program leadership to align billing practices with organizational goals.
Requirements:
- Bachelor's degree (BS/BA) in Accounting, Finance, Business Administration, or related field required; an equivalent combination of education, training, and relevant work experience may be considered.
- 3–5 years of relevant billing, revenue cycle, or healthcare/human services billing experience required, including leadership experience.
- Strong knowledge of Medicaid billing, MNITS, insurance billing practices, and third-party payer/MCO requirements required.
- Advanced Excel skills required; comfort with AI-assisted billing and reporting tools preferred.
- Highly organized and analytical, with the ability to lead a team while managing a complex, high-volume AR portfolio.
- Experience with waiver billing and familiarity with waiver services preferred.
- Billing and coding certificate preferred.
- Experience with prior authorizations and MCO requirements required.