Billing Director Homecare
Billing & Revenue Cycle Oversight
Oversees all billing functions for CHHA services, including Medicare, Medicaid, Managed Care, Medicare Advantage, and commercial payers.
Ensures accurate and timely submission of claims in compliance with NYSDOH, CMS, and payer-specific requirements.
Monitors billing timeliness, denial rates, payment variances, and aging accounts receivable.
Works collaboratively with finance to reconcile revenue, cash posting, and payer remittances.
Regulatory & Compliance Responsibilities
Ensures compliance with:
- NYSDOH CHHA regulations
- CMS Medicare Conditions of Participation
- Medicaid billing and managed care requirements
- Maintains readiness for NYSDOH and CMS audits and surveys
- Ensures billing practices align with:
- OASIS completion
- Physician orders
- Plan of Care certification and recertification
- Visit documentation standards
- Participates in corrective action plans related to billing, documentation, or compliance findings
Interdepartmental Coordination
Works closely with:
- Intake and Authorization teams to ensure services are authorized and billable
- Clinical leadership to resolve documentation or order deficiencies
- Quality Assurance to address audit findings and improve compliance
- Identifies system or process gaps that impact billing accuracy or timeliness and implements solutions
Data, Reporting & Performance Monitoring
Develops and reviews billing and revenue reports, including:
- Denials and rejections
- Authorization issues
- Days in A/R
- Missed or delayed billing opportunities
Provides regular performance reports to executive leadership.
Uses data to identify trends, risks, and opportunities for improvement.
Staff Leadership & Development
Ensures billing staff are trained and competent in current billing rules and payer requirements.
Establishes clear workflows, accountability, and productivity expectations.
Supports ongoing education related to regulatory changes and payer updates.