Associate Director- Revenue Cycle Hospital Billing

Guidehouse•San Antonio, TX

About The Position

The Hospital Billing Associate Director – Revenue Cycle oversees teams responsible for the daily operations of hospital billing, ensuring timely, accurate, and compliant submission of facility claims. The role provides day-to-day leadership and technical guidance to billing staff; monitors productivity and quality; manages claim edits and billing holds; and works with internal departments and payers to resolve issues that delay claim submission or reimbursement. The Associate Director ensures established billing goals and client service expectations are met while maintaining compliance with federal and state regulations, payer requirements, and organizational policies. The role identifies billing trends, implements process improvements, supports staff development, and communicates operational issues and recommendations to management. The position also oversees claim workflows, billing reports, reconciliations, quality reviews, performance indicators, and corrective action planning. It serves as an escalation point for complex billing issues and collaborates with Patient Access, Health Information Management, Coding, Utilization Management, Revenue Integrity, IT, payers, clearinghouses, and other stakeholders.

Requirements

Bachelor’s degree and a minimum of ten years of relevant experience, or a high school diploma and fourteen years of relevant experience.
A minimum of four years of leadership, supervisory, or people-management experience.
Experience managing multiple facility posting data.
Knowledge of financial institution EFT conversion.
Extensive knowledge of blended payments, including hospital billing, physician billing, vendor payments, and general ledger transfers.
Hospital/facility billing or Patient Financial Services experience.
Strong understanding of hospital revenue cycle operations and accounts receivable.
Working knowledge of government and commercial payer billing requirements.
Ability to manage competing priorities and make timely operational decisions.
Ability to communicate effectively with staff, management, clients, payers, and cross-functional departments.

Nice To Haves

Extensive hospital billing experience.
Experience with Epic Hospital Billing (HB), Meditech 6, and/or Meditech Magic.
Experience managing claim edit and billing work queues.
Knowledge of Medicare and Medicaid hospital billing requirements.
Familiarity with CPT, HCPCS, ICD-10, revenue codes, claim forms, and hospital reimbursement methodologies.
Experience with billing scrubbers, clearinghouses, electronic claim submissions, and payer portals.
Experience developing or monitoring hospital billing KPIs and productivity standards.
Intermediate to advanced Microsoft Excel skills.

Responsibilities

Provide daily leadership, direction, coaching, and support to hospital billing staff.
Set expectations for productivity, quality, attendance, and performance, and monitor individual and team results against operational goals and KPIs.
Train staff on billing requirements, payer updates, regulatory changes, and departmental procedures; identify development opportunities and provide feedback.
Ensure staff have the tools, training, system access, and operational knowledge needed to perform their work.
Oversee daily hospital claim billing activities and ensure claims are generated, reviewed, corrected, and released within established timelines.
Monitor billing work queues, claim edits, claim holds, unbilled accounts, electronic submissions, payer rejections, clearinghouse edits, and billing exceptions through resolution.
Ensure billing staff resolve edits or route accounts to the appropriate department, document work in the patient accounting system, and follow corrected, replacement, and adjusted claim workflows.
Monitor reconciliation activities to ensure released claims progress successfully through the billing process.
Research and resolve billing issues, escalate issues when necessary, and work with payers, clearinghouses, internal departments, and other stakeholders to address recurring problems.
Monitor billing accuracy, claim quality, productivity, timeliness, aging inventory, backlogs, and other performance indicators.
Develop action plans to reduce billing delays, prevent avoidable rework, address performance gaps, and implement sustainable solutions to recurring issues.
Perform or coordinate quality reviews and ensure staff follow established billing procedures and inventory prioritization and aging expectations.
Serve as an escalation point for complex hospital billing issues and collaborate across revenue cycle departments to resolve issues affecting claims.
Communicate payer billing changes and requirements to staff and affected departments, and work with IT and system support teams on issues and workflow or system changes.
Ensure billing complies with applicable regulations, payer requirements, organizational policies, and established authorization and adjustment policies.
Educate staff on billing practices and compliance expectations, escalate potential concerns, and support audits and corrective actions.
Prepare, review, and distribute daily, weekly, and monthly hospital billing reports; provide management with updates on barriers, backlogs, payer issues, and operational risks.
Ensure reports, reconciliations, and assigned projects are completed accurately and on time.
Evaluate billing workflows, identify root causes of process failures, maintain standardized procedures and training materials, and support technology, payer, system, and revenue cycle initiatives.
Conduct team meetings to communicate operational updates, performance results, payer changes, and process improvements.