POSITION TITLE:
Senior Director of Billing and Regional Center Relations
REPORTS TO:
Chief Executive Officer
SUPERVISORY RESPONSIBILITY:
Part-Times Billing and Quality Assurance Coordinator and other assigned revenue-cycle personnel
POSITION SUMMARY
The Senior Director of Billing and Regional Center Relations leads CAPC’s revenue-cycle operations and serves as the principal organizational liaison for Regional Center authorizations, billing, rates, vendorization, fiscal matters, and related reporting. The position protects CAPC’s revenue by ensuring that eligible services are authorized, supported, billed, reconciled, collected, and reported accurately while maintaining effective relationships across CAPC’s funding partners.
PAY SCALE: $73,000 - $78,000 Annually
Revenue-Cycle Leadership
· Own the end-to-end monthly billing cycle across Regional Centers, programs, service codes, and other assigned funding sources.
· Establish a written billing calendar, departmental cutoffs, review steps, final submission controls, backup procedures, and continuity plans.
· Validate billing against active authorizations, approved rates, unit rules, service schedules, and required supporting documentation.
· Ensure claims are submitted accurately and timely and evidence of preparation, review, approval, and submission is retained.
· Monitor unbilled services, billing holds, denials, underpayments, overpayments, aging receivables, adjustments, and write-off recommendations.
· Coordinate payment research, corrections, rebilling, recovery, and month-end reconciliation with accounting.
Authorization and Rate Management
· Maintain a centralized authorization record including individual, payer, service code, rate, unit type, effective dates, authorized units, utilization, and expiration.
· Provide service leadership with advance notice of authorizations that are expiring, insufficient, missing, or inconsistent.
· Resolve authorization, rate, and service-code discrepancies with Regional Centers and CAPC leadership.
· Prevent billing that exceeds authorizations, lacks support, uses an incorrect rate, or otherwise fails established requirements.
· Maintain current guidance and source documentation for rates, billing rules, payer changes, and submission procedures.
Regional Center Relations and Growth
· Serve as CAPC’s lead contact for Regional Center fiscal, vendorization, rate-setting, billing, contract, and administrative matters.
· Coordinate with the VP of Services on programmatic relationships with service coordinators and other service personnel.
· Support expansion into additional Regional Center service areas, including vendorization, new service codes, rates, location requirements, and payer readiness.
· Maintain a relationship and issue log showing commitments, owners, due dates, and unresolved matters.
· Escalate significant payer, authorization, collection, or compliance concerns to the CEO.
Analysis and Reporting
· Prepare monthly revenue and utilization reporting by Regional Center, program, team, service code, and other meaningful dimensions.
· Produce the Regional Center revenue breakdown for CAPC’s monthly Board financial dashboard.
· Explain significant fluctuations in billing, collections, utilization, authorizations, and unbilled services.
· Develop revenue projections using active authorizations, service capacity, utilization, rates, and collection history.
· Identify operational causes of lost or delayed revenue and recommend corrective action.
Controls, Audit, and Team Leadership
· Maintain complete billing, authorization, remittance, reconciliation, and audit-support records according to applicable requirements.
· Supervise the Billing and Quality Assurance Coordinator while preserving the Coordinator’s direct escalation access to the CEO for suspected unsupported billing, falsification, retaliation, or unresolved material compliance concerns.
· Ensure Billing personnel do not create, backdate, or improperly modify service-delivery records.
· Place unsupported or questionable items on billing hold and refer material concerns to the CEO.
· Develop written procedures, train assigned staff, establish performance expectations, and maintain adequate cross-training.
· Provide billing-readiness and authorization training to service leaders and administrative personnel.
Decision-Making Authority
· Approve routine billing corrections and submissions after required control steps are complete.
· Place claims on hold when authorization, documentation, rate, or integrity concerns exist.
· Communicate directly with Regional Center fiscal and vendorization representatives on behalf of CAPC.
· Assign work and evaluate supervised billing personnel.
· Recommend write-offs, staffing, systems, payer strategies, and corrective actions; final approval remains subject to CAPC policy.
· May no create missing service documentation, approve unsupported billing, execute contracts, or waive material requirements
Key Working Relationships
· CEO; VP of Services; VP of Operations; VP of Development; accounting team.
· Billing and Quality Assurance Coordinator; Service Directors, Case Managers, schedulers, and other assigned billing personnel.
· Regional Center fiscal, vendorization, rate, contract, and service-coordination representatives.
Performance Indicators
· At least 98% of eligible services billed by the established monthly deadline.
· Unbilled eligible services maintained below 2%, excluding documented payer or authorization delays outside CAPC’s control.
· Monthly billing-to-remittance-to-accounting reconciliation completed on schedule.
· Authorization expirations identified at least 30–60 days in advance.
· Denials, underpayments, and material variances researched within five business days.
· No billing knowingly submitted without active authorization and sufficient supporting documentation.
· Regional Center dashboard delivered with the monthly financial package.
· Reduction in preventable write-offs, late claims, recurring errors, and delayed collections.
QUALIFICATIONS
Required
· Bachelor’s degree in accounting, business, healthcare administration, nonprofit management, or a related field; substantial directly related experience may be considered
· Five years of billing, revenue-cycle, accounts receivable, payer, or funding-source administration experience.
· Supervisory, team-lead, or significant project-lead experience.
· Demonstrated ability to reconcile complex data and explain financial and operational variances.
· Advanced Excel skills and proficiency with billing, reporting, and document-management systems.
· Strong integrity, discretion, attention to detail, and written communication.
Preferred
- Regional Center billing, vendorization, rate, or authorization experience.
- Experience in intellectual and developmental disability services or another government-funded human-services setting.
- Experience building dashboards, billing controls, procedures, and audit-ready records
- Bilingual ability relevant to CAPC’s service area.
Core Competencies
· Revenue-cycle ownership and analytical discipline.
· Relationship building with funding partners.
· Control-minded judgment and ethical decision-making.
· Clear cross-functional communication and issue resolution.
· Deadline management, accuracy, and continuous improvement.
Other Requirements and Working Conditions
· Ability to work onsite as required for records, collaboration, audit support, and operational continuity.
· Ability to work limited additional hours around approved billing deadlines when necessary.
· Valid California driver’s license and insurability when travel is an essential assigned duty.
· Successful completion of applicable background and organizational requirements.
· Reasonable accommodations will be considered in accordance with applicable law.
Pay: $73,000.00 - $78,000.00 per year
Benefits:
- 401(k)
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Professional development assistance
- Referral program
- Retirement plan
- Tuition reimbursement
- Vision insurance
Work Location: In person
