What are the responsibilities and job description for the Director of Billing and UR position at The River Source Casa Grande, LLC?
Position Overview:
The Director of Billing and UR will lead all aspects of the billing department and utilization review processes. This includes ensuring accurate claims submission, maximizing reimbursements, maintaining compliance with insurance requirements, and leading a dedicated team. This role works closely with leadership and clinical teams to ensure that documentation and authorizations align with insurance guidelines and promote positive outcomes.
Key Responsibilities:
- Oversee and manage the daily operations of the billing and UR teams
- Ensure timely submission of clean claims and proactive follow-up on outstanding accounts
- Supervise utilization review processes, including authorizations, concurrent reviews, and documentation tracking
- Maintain compliance with payer requirements, HIPAA regulations, and industry standards
- Analyze billing and UR metrics to identify trends, resolve issues, and improve performance
- Collaborate with clinical, admissions, and administrative departments to support accurate and efficient workflows
- Train and mentor staff to ensure consistent, high-quality performance and understanding of evolving billing guidelines
- Monitor changes in insurance regulations and payer policies to ensure ongoing compliance
Qualifications:
- Bachelor’s degree in Healthcare Administration, Business, or related field
- Minimum 2 years of experience in medical billing and utilization review, preferably in a behavioral health or substance abuse setting
- At least 2 years of leadership experience managing billing or UR teams
- Strong understanding of insurance verification, authorizations, coding, claims, and appeals
- Experience working with commercial and Medicaid payers
- Proficient in EHR and billing software systems
- Excellent leadership, analytical, and communication skills
Job Type: Full-time
Pay: $70,000.00 - $80,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Vision insurance
Schedule:
- Monday to Friday
- Weekends as needed
Experience:
- Leadership: 2 years (Preferred)
Ability to Commute:
- Gilbert, AZ 85233 (Required)
Ability to Relocate:
- Gilbert, AZ 85233: Relocate before starting work (Required)
Work Location: In person
Salary : $70,000 - $80,000
