Director, Billing and Accounts Receivable
community care cooperativeSomerville, MA
Director, Billing and Accounts Receivable
L7
community care cooperativeSomerville, MA8 days ago
Overview:
In this role you will lead the billing and accounts receivable functions for FQHC partners on our Epic instance and Share Services model. You will manage a team, ensure regulatory compliance, and optimize AR performance to support C3 and partner financial goals. You will collaborate with Revenue Integrity and Credentialing to refine claim logic and workflows, leveraging Epic to drive efficient revenue cycle operations. This is a chance to shape billing strategy within a mission-driven MSO/ACO environment and contribute to Massachusetts healthcare delivery.
Responsibilities:
- Supervise and mentor the billing team to maintain accuracy and productivity
- Drive the vision for C3 as a leading MSO in Billing and Credentialing
- Foster cross-functional collaboration with MSO, C3, and Health Centers leadership
- Conduct regular performance reviews and address issues promptly
- Maintain up-to-date billing and collections policies and procedures
- Identify and implement process and technology improvements for revenue cycle efficiency
- Oversee AR, insurance, and self-pay collections
- Manage daily billing operations for FQHCs and ensure timely claims processing
- Monitor billing processes and drive improvements and solutions
- Ensure timely reconciliation of transmitted claims
- Utilize Epic WQs to segment work and maintain productivity
- Perform denial trend analysis and root cause analysis to reduce denials
- Serve as primary contact for Epic-related billing configurations and workflows
- Collaborate with IT/CTC to resolve technical issues and implement system updates
- Follow ticket management processes for system support
- Prepare regular revenue cycle reports, KPIs, and month-end results
- Define and meet AR management and cash collection goals
- Analyze data to identify revenue growth opportunities and process enhancements
- Develop strategies to reduce denials and improve collections
- Ensure billing activities comply with state and federal regulations for FQHCs and MAMaintain knowledge of Medicaid, Medicare, and commercial policies
- Collaborate with clinical, administrative, and finance teams for alignment
- Coordinate with vendors/third parties for data capture and collections
- Represent billing in audits, meetings, and planning sessions
- Uphold service excellence aligned with C3's mission and values
- Other duties as assigned
Key requirements:
- Epic systems proficiency (configuration and reporting)7–10 years of healthcare billing experience with 3–5 years in management
- Strong knowledge of Massachusetts healthcare billing regulations and payer requirements
- Leadership and excellent cross-stakeholder communication
- Results-driven, innovative, organized, and Able to navigate ambiguity
- Experience with quality improvement, change management, and project management
- Proficiency with Microsoft Office Suite
- Commitment to quality assurance and customer service
- Strong alignment with organizational missionleadershipcommunicationattention to detail
- Epic (configuration, reporting, WQ usage)
- Epic billing modules (e.g., charge router, Resolute)
- Billing and revenue cycle analytics
Apply now (opens in a new tab)
Level
ManagerL7
Location
Somerville, MA
Occupation
Medical and Health Services Managers
Industry
General Medical and Surgical Hospitals
Posted
8 days ago
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