The Billing Leader is a critical role within Healthrise, responsible for ensuring accurate, timely, and efficient billing of claims across our hospital and health system clients. This leader will oversee a large operational team while also serving as the visionary for how Healthrise builds, scales, and optimizes this program into a true differentiator within our RCMS division.

Success in this role requires deep subject matter expertise in billing, strong operational leadership across domestic and offshore teams, and the ability to partner with senior leaders to define the future-state strategy. This leader must not only deliver flawless execution but also build scalable frameworks that improve accuracy, efficiency, and overall client outcomes.

Operational Leadership

• Lead, manage, and develop a large team of Billing staff across both domestic and offshore locations, supporting multiple client organizations simultaneously.
• Ensure daily billing activities are executed with accuracy, timeliness, and compliance to each client’s standards and requirements as well as regulatory guidelines.
• Oversee billing edits, rejections and secondary, tertiary billing processes to ensure all claims are billed to payors timely and appropriately. Ensure that all billing regulations standards are adhered to and resolved appropriately and effectively.
• Oversee daily activities of billing teams, both global and domestic. 
• Drive accountability against key SLAs and KPIs, including turnaround times, accuracy rates, and error reduction.

Performance Oversight and Governance

• Own the performance of the Billing function across all clients, ensuring outcomes align with Healthrise standards and contracted SLAs.
• Monitor KPIs and proactively identify underperformance, driving timely resolution before client impact occurs.
• Serve as the escalation point for Billing concerns raised by Client Delivery Leaders, addressing issues effectively and decisively.
• Lead regular performance reviews with RCMS leadership, identifying risks, recommending improvements, and ensuring continuous optimization.

Program Development & Optimization

• Partner with Senior RCMS Operational Leaders to design a best-in-class Billing program tailored to Healthrise’s client base and growth objectives.
• Act as the visionary for how the Billing function evolves, defining the roadmap, operating model, and future-state structure to support scale.
• Collaborate with technology teams to drive automation, RPA, and workflow enhancements within internal systems and client EHR platforms (Epic, Oracle, Meditech, etc.).
• Establish scalable frameworks, policies, and training programs to ensure consistent, high-quality delivery across multiple clients.

Client Partnership & Governance

• Act as a subject matter expert and trusted advisor to clients on Billing and reconciliation best practices.
• Participate in client governance meetings, providing transparency on performance, challenges, and improvement initiatives.
• Build strong credibility with hospital finance and revenue cycle leaders through disciplined execution, thought leadership, and proactive communication.

Qualifications

• Proven leadership experience in healthcare revenue cycle management, specifically in Billing, cash applications, or payment reconciliation.
• Strong working knowledge of Epic and its Billing/reconciliation modules, with ability to optimize workflows within Epic environments.
• Strong knowledge and understanding of billing clearinghouses. 
• Extensive experience managing both domestic and offshore teams, ensuring seamless coordination and performance across geographies. Ability to travel domestically and internationally as needed.
• Track record of implementing scalable frameworks, driving automation, and improving efficiency within Billing operations.
• Strategic mindset with the ability to set a long-term vision while maintaining disciplined focus on day-to-day performance.
• Excellent client-facing skills, with proven ability to communicate effectively with CFOs, revenue cycle VPs, and finance leaders and ability to provide reporting and audit support as needed. 
• Demonstrated ability to expand client engagements by leveraging scalable frameworks, delivering enhanced value for both clients and Healthrise. 
• Bachelor’s degree preferred or equivalent experience; and certifications (CRCR, HFMA, etc.) preferred.

Measurements of Success

• Achievement of SLA and KPI targets for Billing accuracy, timeliness, and reconciliation.
• Growth in total revenue impact of Billing operations within individual projects and across all Healthrise-supported clients.
• Demonstrated improvements in efficiency, automation adoption, and cost management.
• Positive client feedback and measurable financial impact from improved Billing operations.
• Effective collaboration with Senior RCMS Operational Leaders and Client Delivery Leaders, strengthening overall client delivery outcomes.