Directs and develops billing staff, establishes and monitors performance expectations, and partners with EMS operations, Revenue Cycle, Finance, payers, and other organizational stakeholders to optimize revenue realization, reduce accounts receivable, resolve billing and payer issues, and improve the overall patient financial experience. Develops, maintains, and analyzes key performance indicators, including point-of-service collections, days in accounts receivable, aging, cash collections, denial rates, clean claim rates, claim submission timeliness, payment variance, productivity, and other department-specific metrics.