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Position Summary

We are seeking an experienced and effective Billing Operations Director to oversee assigned processes within the billing operations group. This role requires strong leadership skills, analytical abilities, extensive knowledge of healthcare billing practices, and a commitment to process improvements.

Job Responsibilities

• Lead and manage billing and appeals specialists and support staff, providing guidance, training, and performance feedback as needed.

• Routinely and proactively interact with clients including hospitals and pathology departments to ensure timely payment of client invoicing.

• Work cross-functionally with client support teams to address client billing concerns.

• Provide leadership to billing teams.

• Oversee the processing of claims and identify trends, patterns, and opportunities for improvement.

• Create and monitor reports and metrics related to production, DSO, and reimbursement rates in order to create action plans aimed at continuous improvement.

• Effectively appeal/respond denied claims and information requests from payers.

• Develop and implement policies, procedures, and workflows with an eye towards continuous improvement.

• Ensure compliance with all relevant regulations, including HIPAA, CMS guidelines, and payer requirements, and implement strategies to minimize denials and optimize reimbursement.

• Collaborate with other departments resolve billing-related issues and streamline processes.

• Monitor key performance indicators (KPIs) related to productivity and develop strategies to achieve departmental goals.

Required Qualifications

• Minimum of 5 years of experience in medical billing/revenue operations in an Oncology or Laboratory settings, with at least 2 years in a supervisory or managerial role.

• In-depth knowledge of medical coding guidelines, regulations, and compliance standards, including ICD-10, CPT, and HCPCS.

• Strong leadership, communication, and interpersonal skills, with the ability to effectively manage a team and collaborate with internal and external stakeholders.

• Excellent analytical and problem-solving abilities, with a focus on accuracy, attention to detail, and process improvement.

• Ability to adapt to changing priorities and work effectively in a fast-paced, dynamic environment.

• Commitment to maintaining confidentiality and integrity in handling sensitive patient information.

• Familiarity with healthcare reimbursement methodologies and revenue cycle management principles.

• Proficiency in using billing software and electronic health record (EHR) systems (Xifin preferred).

• Conditions of Employment: Individual must successfully complete pre-employment process, which includes criminal background check, drug screening and reference verification.

Preferred Qualifications

• Bachelor's degree in healthcare administration, business administration, or a related field preferred.

Physical Demands

• Must possess ability to sit and/or stand for long periods of time.

• Must possess ability to perform repetitive motion.

• Ability to lift up to 25 pounds.

• Majority of work is performed in a desk/cubicle environment.

Training

• All job specific, safety, and compliance training are assigned based on the job functions associated with this employee.

Other

• Willingness to work shift work and overtime is required.

• Travel Required: Rarely.

• Weekends/Evenings/Holidays: No.

This job description reflects management’s assignment of essential functions. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

Caris Life Sciences is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

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