Director, Hospital Billing

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a
** full-time equivalent (1.0 FTE)
** position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).
** Scheduled Weekly

Hours:

** 40
* * Position Overview**## SUMMARY Provides operational leadership for all hospital billing functions, including inpatient, outpatient, emergency, and ancillary services. This role is accountable for billing accuracy, timeliness, compliance, and optimization of net patient revenue. Director oversees billing operations across revenue cycle and ensures alignment with regulatory requirements, payer contracts, and organizational financial goals. Collaborates closely with Finance, Revenue Integrity, HIM/Coding, CDI, Patient Access, Utilization Review, Denials Management, Compliance, and Information Technology to ensure efficient billing workflows and optimal cash flow.##

MINIMUM REQUIREMENTS

Education:

High school diploma or equivalent required. Bachelor’s degree in business, finance, accounting, or related discipline preferred.

Experience:

Ten years hospital billing and three years management experience required.

Knowledge and

Skills:

Strong understanding of ICD-10/CPT coding, revenue codes and medical terminology. Strong critical thinking and problem-solving skills. Ability to work independently and execute multiple projects while managing team members. Strong attention to detail to ensure accuracy. Excellent verbal, written, and interpersonal communication skills

Special Training:
Proficient in Microsoft Office.

Mental, Behavioral and Emotional Abilities:

Usual Work Day: 8 Hours## Reporting Relationships If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.## ESSENTIAL FUNCTIONS
* Directs all hospital billing activities for inpatient and outpatient services.
* Oversees billing functions including claim generation, edits, corrections, and final submission.
* Ensures accurate and timely billing in accordance with CMS, payer, and contractual requirements
* Standardizes billing workflows across facilities to ensure consistency and scalability.
* Accountable for billing-related KPIs such as clean claim rate, billing lag, days in accounts receivable (AR), and claim rejection and denial rates.
* Partners with Revenue Integrity and Denials teams to reduce preventable billing errors. Supports net revenue forecasting and variance analysis.
* Drives initiatives to improve cash flow and reduce AR aging.
* Ensures compliance with CMS billing regulations, Medicare/Medicaid billing rules, payer contract requirements, and Federal and state healthcare regulations.
* Leads billing compliance audits and corrective action plans. Collaborates with Compliance and Legal to mitigate billing risk.
* Maintains audit readiness and documentation standards. Manages development, implementation, and continuously evaluates the need for revision to departmental policies and procedures.
* Oversees hospital billing workflows within the EHR and billing systems.
* Collaborates with IT and Revenue Cycle leadership on system configuration, upgrades, testing, and optimization. Drives automation and standardization to reduce manual intervention and rework.
* Leads and develops billing managers, supervisors, and staff.
* Establishes performance standards, productivity benchmarks, and quality…