Dir, PB Specialty Billing, No Response

UMass Memorial Health•Worcester, MA

About The Position

The Director, PB Specialty Billing & No Response is a key leadership role within the Accounts Receivable department, responsible for overseeing specialty billing operations, managing no response accounts, facilitating new acquisitions, and executing strategic projects. This position ensures optimal performance and compliance across all assigned functions, driving efficiency and effectiveness in revenue cycle processes. This position reports directly to the AVP of Accounts Receivable and manages a team of specialty billing and no response staff.

Requirements

Bachelor’s degree in Accounting, Finance, Business Administration, or related field
Minimum of 7 years of experience in accounts receivable, billing operations, or revenue cycle management, with at least 3 years in a supervisory or Director-level role.
Proven experience managing specialty billing and no response accounts.
Strong leadership, communication, and project management skills.
Ability to work collaboratively across departments and with external partners.
Proficiency in billing software and financial reporting tools.
Demonstrated problem-solving and analytical abilities.

Nice To Haves

Master’s degree

Responsibilities

Specialty Billing Management: Oversee and direct the specialty billing team, ensuring accurate and timely billing for all specialty services. Develop and implement best practices and procedures to maximize reimbursement and minimize denials.
No Response Oversight: Manage the identification, follow-up, and resolution of no response accounts. Coordinate with payers, providers, and internal teams to address outstanding claims and reduce aging accounts receivable.
New Acquisitions Integration: Lead and support the integration of newly acquired entities into the existing billing and accounts receivable processes. Develop transition plans, train staff, and ensure seamless onboarding and compliance with organizational standards.
Project Leadership: Initiate, plan, and execute strategic projects related to specialty billing, no response accounts, and revenue cycle improvements. Collaborate with cross-functional teams to achieve defined objectives and deliver measurable results.
Staff Management: Supervise, mentor, and evaluate assigned staff members. Set performance goals, conduct regular reviews, and provide professional development opportunities to foster a high-performing team environment.
Reporting & Analysis: Prepare and present regular reports on specialty billing, no response accounts, and acquisition integration outcomes. Analyze trends, identify areas for improvement, and recommend solutions to senior leadership.
Compliance & Quality Assurance: Ensure all billing and accounts receivable activities are conducted in accordance with applicable laws, regulations, and company policies. Monitor quality standards and implement corrective actions as needed.
Directs and supervises assigned personnel including performance evaluations, scheduling, orientation, and training. Makes recommendations on employee hires, transfers, promotions, salary changes, discipline, terminations, and similar actions. Resolves grievances and other personnel problems within position responsibilities.
Develops and recommends the budgets for the areas managed. Manages activities to assure financial goals are met.
Coordinates the assignment of tasks and helps resolve technical and operational problems. Evaluates the impact of solutions to ensure goals are achieved.
Provides effective direction, guidance, and leadership over the staff for effective teamwork and motivation; and fosters the effective integration of efforts with system-wide initiatives.
Encourages and supports diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, respect, tolerance, civility and acceptance toward all employees, patients, and visitors.
Integrates diversity into departmental objectives, such as hiring, promotions, training, vendor selections, etc.
Participates in performance improvement initiatives and demonstrates the use of quality improvement in daily operations.
Ensures compliance with regulatory agencies such as Joint Commission, DPH (Department of Public Health), etc. Develops and maintains procedures necessary to meet regulatory requirements.
Ensures that department complies with hospital established policies, quality assurance programs, safety, and infection control policies and procedures.
Ensures adequate equipment and supplies for department.
Develops and maintains established departmental policies, procedures, and objectives.
Ensures compliance to all health and safety regulations and requirements.
Maintains, regular, reliable, and predictable attendance.
Performs similar or related duties as required or directed. All responsibilities are essential job functions.