Confidential Director of Billing – Skilled Nursing / Long-Term Care
Position Overview
A multi-facility healthcare management organization is conducting a confidential search for an experienced Director of Billing to oversee billing and revenue cycle functions across a portfolio of skilled nursing facilities.
This position is responsible for oversight, accuracy, timeliness, and performance of facility billing operations. The Director of Billing will provide direct supervision and leadership to billing personnel while working closely with facility and corporate teams to ensure claims are submitted accurately, accounts receivable is actively managed, reimbursement issues are identified and resolved, and revenue cycle processes are consistently followed while monitoring cash collections for all insurance payers throughout the month.
The successful candidate will have significant experience with skilled nursing facility billing and reimbursement, demonstrated supervisory experience, and a strong understanding of Medicare, Medicaid, managed care, commercial insurance, private pay, and other payer sources.
Key Responsibilities
Revenue Cycle & Billing
- Provide oversight of billing and revenue cycle operations for multiple skilled nursing facilities.
- Monitor the complete revenue cycle from census and payer verification through billing, collections, payment posting, and account resolution.
- Ensure timely and accurate submission of claims to Medicare, Medicaid, managed care organizations, commercial insurance carriers, and other third-party payers.
- Monitor accounts receivable aging reports and identify accounts requiring additional follow-up or escalation.
- Review billing performance and address trends affecting cash collections, outstanding receivables, and reimbursement.
- Monitor Days Sales Outstanding (DSO) and other revenue cycle performance indicators.
- Oversee denial management, claim corrections, resubmissions, appeals, and reimbursement follow-up.
- Ensure appropriate follow-up on outstanding Medicare, Medicaid, managed care, insurance, and private-pay balances.
- Monitor census, payer classifications, authorizations, eligibility, and supporting documentation for potential reimbursement issues.
- Review month-end billing activity and assist with revenue cycle close processes.
- Monitor cash collections and compare performance against established expectations.
- Develop and maintain standardized billing procedures across assigned facilities.
- Monitor compliance with applicable federal and state billing requirements.
- Support internal audits and reviews of billing documentation and revenue cycle practices.
- Prepare and review reports related to accounts receivable, collections, aging, denials, billing status, and other revenue cycle metrics.
Supervisory & Leadership Functions
- Provide direct supervision, leadership, and oversight of billing department personnel as well as the abi
- Establish departmental expectations, priorities, workflows, performance standards and goals.
- Assign and monitor workloads to ensure billing and collection responsibilities are completed accurately and within established deadlines.
- Assist with interviewing, selecting, onboarding, and training new billing team members.
- Evaluate staff performance and address performance concerns when appropriate.
- Maintain appropriate staffing levels and distribute responsibilities based on operational needs.
- Serve as an escalation point for complex claims, reimbursement issues, payer disputes, and accounts requiring additional intervention.
- Ensure billing personnel consistently follow established policies, procedures, and internal controls.
- Develop and implement processes designed to improve departmental efficiency and accountability.
- Provide education and guidance to facility Business Office Managers regarding billing and revenue cycle expectations.
- Coordinate with operations, finance, clinical reimbursement, admissions, and facility leadership when issues affect billing or collections.
- Communicate departmental performance, significant outstanding receivables, reimbursement risks, and other revenue cycle concerns to senior leadership.
- Hold team members accountable for timely follow-up and resolution of assigned accounts.
- Perform additional supervisory and revenue cycle responsibilities as assigned.
Qualifications
- Prior experience in skilled nursing facility billing and revenue cycle management required.
- Prior experience supervising or managing billing, accounts receivable, or revenue cycle personnel required.
- Multi-facility and multi-state experience required.
- Strong working knowledge of Medicare, Medicaid, managed care, commercial insurance, and private-pay billing.
- Experience managing accounts receivable, collections, denials, claims follow-up, and reimbursement issues.
- Understanding of SNF reimbursement processes and payer requirements.
- Demonstrated ability to manage staff performance, establish expectations, and maintain accountability.
- Experience working with facility Business Office Managers and centralized billing teams.
- Ability to review revenue cycle reports and identify trends requiring corrective action.
- Strong organizational, analytical, and problem-solving skills.
- Ability to manage multiple facilities, employees, priorities, and deadlines.
- Proficiency with healthcare billing systems, electronic claims processes, and Microsoft Excel.
- Experience with commonly utilized skilled nursing financial, billing, or clinical systems is preferred.
Experience
- Skilled Nursing / Long-Term Care Billing: Required
- Revenue Cycle Management: Required
- Medicare & Medicaid Billing: Required
- Accounts Receivable / Collections: Required
- Staff Supervision / Management: Required
Additional Information
This is a confidential search. Specific information regarding the organization, facility portfolio, reporting structure, team size, and additional position details will be discussed with qualified candidates during the interview process.
Candidates should have direct experience managing the complexities of skilled nursing revenue cycle operations and demonstrated experience supervising billing personnel and driving accountability for revenue cycle performance across multiple locations.
Pay: $120,000.00 per year
Application Question(s):
- How many years of billing and revenue cycle experience do you have specifically within skilled nursing facilities (SNFs) or long-term care?
- Briefly describe the largest skilled nursing or long-term care portfolio you have supported. Please include the approximate number of facilities and your responsibilities related to billing, A/R, collections, and revenue cycle performance.
- Describe your experience managing aging accounts receivable. What metrics do you typically monitor, and what steps have you taken to improve collections or reduce outstanding A/R?
- What skilled nursing billing, financial, or clinical systems have you worked with?
Examples may include PCC, MatrixCare, billing clearinghouses, payer portals, or other revenue cycle platforms.
- This position requires significant involvement in the overall revenue cycle—not simply claim submission. Briefly describe your experience overseeing the revenue cycle from census/payer setup through billing, collections, payment posting, denial resolution, and account follow-up.
- What are your current salary expectations for a Director-level billing/revenue cycle position?
Work Location: Remote
