Director of Physician Compensation & Physician Billing

Key Responsibilities

• Billing Operations Management
  • Oversee the end-to-end physician billing process, including charge capture, coding, claims submission, payment posting, and accounts receivable management.
  • Develop and implement billing policies and procedures to ensure accuracy and compliance with state and federal regulations.
  • Monitor and analyze billing performance metrics, identifying areas for improvement and implementing corrective actions.
• Compensation Management
  • Develop and manage physician compensation plans, ensuring they are competitive, equitable, and aligned with organizational goals.
  • Conduct regular market analyses to keep compensation plans up-to-date with industry standards.
  • Familiar with MOMA and AAMC compensation programs.
  • Collaborate with HR and department heads to ensure physician compensation plans are effectively communicated and understood.
• Revenue Cycle Optimization
  • Collaborate with clinical and administrative staff to optimize revenue cycle processes and enhance financial performance.
  • Implement best practices in revenue cycle management to maximize reimbursement and minimize denials.
  • Regularly review and update billing software and systems to enhance efficiency and accuracy.
• Compliance and Audit
  • Ensure compliance with all relevant billing and compensation regulations, including CMS, HIPAA, and other state and federal guidelines.
  • Coordinate internal and external audits related to billing and compensation, and implement recommendations as needed.
• Leadership and Team Management
  • Lead and mentor the billing and compensation teams, fostering a culture of continuous improvement and professional development.
  • Conduct regular performance reviews and provide feedback to team members.
  • Develop and maintain strong working relationships with physicians, administrators, and other stakeholders.
• Financial Reporting and Analysis
  • Prepare regular financial reports on billing and compensation metrics for senior management.
  • Analyze financial data to identify trends and opportunities for improvement.
  • Work with the CFO to develop and manage departmental budgets.

Qualifications

• Required:
  • Bachelor's Degree in Healthcare Administration, Business Administration, Finance, Accounting, Health Information Management, or a related field.
  • Minimum of 8 years of progressive experience in physician revenue cycle, physician billing, physician compensation, healthcare finance, or physician practice management.
  • Minimum of 5 years of leadership experience managing teams and operational functions.
  • Demonstrated expertise in professional (physician) billing, coding, charge capture, revenue cycle operations, and reimbursement.
  • Experience administering physician compensation programs, including work RVU (wRVU)-based compensation models and incentive plans.
  • Working knowledge of Medicare and commercial payer reimbursement, CPT/HCPCS/ICD-10 coding, Stark Law, Anti-Kickback Statute, and Fair Market Value (FMV) principles.
  • Strong analytical, financial, and communication skills with experience presenting to physician and executive leadership.
  • Proficiency with electronic health record (EHR) and revenue cycle systems, as well as advanced Microsoft Excel.
• Preferred:
  • Master's Degree in Business Administration (MBA), Healthcare Administration (MHA), Finance, or a related field.
  • Professional certification such as HFMA, MGMA, AAHAM, CPA, or other relevant healthcare finance or revenue cycle credential.
  • Experience in an academic medical center or large integrated health system.
  • Experience with Epic Professional Billing/Resolute or other enterprise physician billing platforms.
  • Knowledge of physician compensation benchmarking tools (e.g., MGMA, SullivanCotter, Vizient) and provider productivity analytics.
  • Experience with business intelligence and reporting tools such as Power BI, Tableau, or SQL.
  • Demonstrated success leading strategic initiatives to improve physician billing performance, compensation administration, operational efficiency, and regulatory compliance.