Billing Director

Job Description

Job Description

Description:

About Ally Psychiatry

Ally Psychiatry is a rapidly growing middle-market behavioral healthcare company dedicated to improving patient access to high-quality psychiatric care. We are seeking a detail-oriented, experienced Billing Director to lead our billing and coding operations. This individual will play a critical role in ensuring clean claim submission, reducing denials, and maximizing reimbursement accuracy across all payers.

Why Join Ally Psychiatry

• Opportunity to lead and improve a mission-critical function in a fast-growing mental health company.
• Direct impact on patient access, provider satisfaction, and financial performance.
• Collaborative, mission-driven culture with executive leadership support.
• Competitive compensation, equity participation, and comprehensive benefits.

Position Summary

The Billing Director will be responsible for managing all aspects of the company’s billing and coding functions, ensuring accurate claim generation, timely submission, and proactive denial management. This role requires a hands-on leader with deep knowledge of behavioral health billing, payer requirements, and compliance standards. The Billing Director will partner with clinicians, administrative staff, and finance leadership to drive improvements in billing performance, revenue capture, and operational efficiency through process improvement and automation.

Key Responsibilities

Billing Operations

• Oversee end-to-end billing processes, including charge entry, claim generation, submission, payment posting, and collections.
• Ensure clean claim submission by verifying coding accuracy, insurance eligibility, and charge capture prior to claim release.
• Monitor and manage accounts receivable, reducing aging balances through timely follow-up and resolution.
• Design, implement, and maintain a claims review process to identify errors, trends, and areas for improvement before claim submission.
• Develop and execute plans to address payer issues and rebill projects.

Coding Oversight

• Supervise coding practices to ensure accuracy in CPT, ICD-10, and HCPCS coding specific to psychiatry and behavioral health.
• Provide guidance and training to staff and clinicians on correct coding and documentation requirements.
• Stay current on payer coding rules, medical necessity requirements, and regulatory changes affecting reimbursement.

Denial Prevention & Management

• Analyze denial trends, root causes, and implement corrective actions to minimize denials and rejections.
• Develop and enforce processes to ensure timely appeal and resolution of denied claims.
• Collaborate with clinicians and front-office staff to prevent recurring errors and improve documentation practices.

Process Improvement & Automation

• Identify and implement automation opportunities to streamline billing workflows, reduce manual touches, and improve accuracy.
• Continuously review and optimize billing processes to increase efficiency, reduce errors, and maximize revenue capture.
• Implement dashboards, reports, and analytics tools to track performance and identify improvement opportunities.

Compliance & Audit Readiness

• Ensure compliance with payer contracts, Medicare, Medicaid, and commercial insurance billing requirements.
• Maintain HIPAA compliance in all billing and coding activities.
• Support internal and external audits by providing accurate documentation and timely responses.
• Notify VP of RCM and CFO if there is knowledge of any compliance issues or audits. Notify VP of RCM of any changes in payer policies, billing regulations, or payer inquiries.
• Complete internal audits as directed, communicate findings to VP of RCM and CFO, and prepare and implement mitigation plans to address any deficiencies.

Team Leadership

• Lead and mentor the billing staff, setting performance goals aligned with accuracy, timeliness, and denial reduction.
• Provide ongoing training and development in billing and coding best practices.
• Foster a culture of accountability, process excellence, and continuous improvement.
• Frequently collaborate with Outpatient Clinic Leadership Teams and Front-Line Staff to design and implement front-end processes to streamline submission of clean claims.
• Create closed loop feedback systems with the Collections Team. Provide training and education to the Billing Team to correct denial trends identified by the Collections Team prior to claim submission.
• Identify and Communicate opportunities for revenue enhancement. Collaborate with team members as needed to realize identified opportunities.

Reporting & Metrics

• Present monthly and quarterly performance dashboards with trend analysis and recommendations for improving KPI performance.
• Track and report on billing performance metrics, including clean claim rate, denial rate, days in A/R, and cash collections.
• Measure and report on department and team member productivity as a measure of claims processed per FTE.
• Provide regular updates to the VP of RCM, CFO and executive leadership on revenue cycle performance and improvement initiatives.

Key Performance Indicators (KPIs)

Success in this role will be measured by:

• Clean Claim Rate: = 95–98%
• Denial Rate: = 5% of total claims
• Timeliness of Claim Submission: = 95% of claims submitted within 3–5 days of service
• Days in Accounts Receivable (A/R): = 35 days
• Appeal Success Rate: = 70% of denied claims successfully overturned
• Coding Accuracy Rate: = 95% on internal and external audits
• Collections Effectiveness Index (CEI): = 95%
• Claims Review Effectiveness: Percentage of errors or issues identified prior to claim submission
• Process Improvement Implementation: Number and impact of workflow/automation improvements implemented annually

Required:

• 7+ years of progressive experience in medical billing and coding.
• 3+ years in a leadership role.
• Strong expertise in process improvement and implementing workflow automation.
• Proven success in improving clean claim rates, reducing denials, and optimizing reimbursement.
• Experience with EHR and practice management systems.
• Excellent leadership, communication, and problem-solving skills.

Strongly Preferred:

• Expert knowledge of behavioral health/psychiatry billing practices and payer rules.
• Bachelor’s degree in a business-related field.
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent credentials.