Medical Billing Director - 5709

ColumbiaCare Services•Medford, OR

5d•$100,000 - $125,000•Onsite

About The Position

ColumbiaCare is seeking an experienced Medical Billing Director to lead the billing department and billing functions of a large, multi-geographical and multi-service non-profit behavioral health organization. This leadership position oversees the organization's medical billing, reimbursement, payer relations, and compliance. The ideal candidate is a hands-on billing leader with deep Medicaid behavioral health experience who can quickly assess operations, identify opportunities for improvement, and provide immediate supervision to the billing team and consultation to program and department leaders. Candidates should have direct experience leading Medicaid behavioral health billing operations and be prepared to assume operational oversight. This position will also play a critical role in the organization's active transition to the Cantata Arize electronic health record (EHR) platform, providing leadership and subject matter expertise to ensure billing requirements, workflows, system functionality, and reimbursement processes are effectively designed, implemented, and optimized.

Requirements

Minimum of five (5) years of progressively responsible billing management experience in a Medicaid behavioral healthcare setting.
Prior supervisory or management experience.
Strong expertise in behavioral health billing operations, revenue cycle management, claims processing, denial management, and insurance reimbursement.
Working knowledge of Medicare, Medicaid, commercial insurance billing, payer requirements, and Oregon behavioral health billing regulations.
Experience with electronic health record (EHR) systems, medical billing applications, workflow management systems, and Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint).
Demonstrated ability to analyze complex billing and reimbursement data, identify operational challenges, and implement effective solutions.
Experience collaborating across departments and building productive relationships with payers, regulatory agencies, and external stakeholders.
Must demonstrate the knowledge, attitudes, and skills described in the organization's Core Values and Competencies.
Regular and reliable attendance.
Ability to pass a DHS criminal background check.

Nice To Haves

Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field.
Certified Professional Coder (CPC) certification.
Experience with Cantata Arize or similar behavioral health EHR platforms.
Experience supporting EHR implementations, billing system conversions, or revenue cycle optimization initiatives.

Responsibilities

Provides strategic and operational leadership for the organization's behavioral health billing operations and revenue cycle activities managed within the Billing Department.
Responsible for claims management, payer relations, reimbursement optimization, accounts receivable oversight, billing compliance, and revenue cycle processes from authorization and charge capture through claim adjudication and payment resolution.
Develops and implements policies, procedures, workflows, and system improvements that promote operational efficiency, billing accuracy, regulatory compliance, and financial performance.
Working collaboratively with Finance, Quality, Clinical Services, Operations, Contracts, and Executive Leadership, this position analyzes billing and reimbursement performance, identifies trends and opportunities for improvement, develops actionable solutions, and provides reporting and recommendations that support organizational decision-making and financial sustainability.
Provides leadership, supervision, and professional development to billing staff while fostering a culture of accountability, collaboration, continuous improvement, customer service, and compliance.
Serves as the primary liaison with insurance carriers, managed care organizations, state and county agencies, and other external stakeholders regarding billing, reimbursement, and regulatory matters.
Actively monitors proposed changes to Medicaid billing regulations and Oregon Administrative Rules (OARs), participates in industry and stakeholder forums as appropriate.