Job Description

Job Description

Job Description

Since 1957, Shield Healthcare has provided high-quality healthcare services while focusing on customer satisfaction and employee achievement. We are dedicated to fulfilling the medical supply needs of consumers and the caregiving community while maintaining a 99% overall customer satisfaction rating. Over the years, Shield HealthCare has expanded nationally with current service locations in California, Colorado, Illinois, Ohio, Texas and Washington.

Shield HealthCare is looking for a Director of Billing Operations  in our Valencia, CA  corporate office. The Director of Billing Operations provides strategic, operational, and leadership oversight for the organization’s Billing Operations Department. This role ensures timely and accurate submission of claims, drives departmental performance, maintains compliance with payer and regulatory requirements, and supports organizational revenue and cash flow goals. The Director leads the team while collaborating cross functionally with internal departments and external payers.

This is an on-site position in Valencia, CA.

JOB RESPONSIBILITIES:

• Direct all billing activities to ensure timely payment of claims.
• Establish, refine, and standardize workflows to maximize productivity, accuracy, and turnaround times.
• Ensure adherence to company policies, payer rules, and federal and state regulations.
• Serve as a liaison with Revenue Cycle, Billing, Coding, and Compliance departments, and external payers.
• Develop and execute short and long‑term strategic plans for the Adjudication Department.
• Manage departmental budget, staffing models, and resource allocation.
• Monitor denial patterns and write‑offs; implementing corrective action plans.
• Lead, mentor, coach, and evaluate direct reports. 
• Support direct reports in the development and performance management of billing operations team.
• Conduct performance management actions as needed.
• Establish 90-Day Onboarding plan to support new employees in their role.
• Oversee departmental training programs to ensure staff competency in billing, payer rules, and regulatory updates.
• Partner with Learning & Development team to build departmental training plans.
• Handle multiple priorities with aggressive deadlines, ensuring appropriate follow-up and closure.
• Complete special projects supporting claim management of payments with internal and external stakeholders as assigned, supporting team and organizational objectives and continuous improvement initiatives. 

QUALIFICATIONS:

• Bachelor’s degree in Healthcare Administration, Business Administration, Finance or Accounting, or Health Information Management required; master’s degree preferred.
• 7+ years of experience in healthcare billing, adjudication, or revenue cycle operations.
• 4+ years of leadership experience managing large teams or multi‑level departments.
• Proven ability to coach and mentor team, identifying areas for team and individual development.
• Strong knowledge of payer rules, government programs, and medical billing regulations.
• Experience with healthcare billing/claims systems highly preferred.
• Proficiency in Microsoft 365 (Excel, PowerPoint, Word, SharePoint, Teams).
• Advanced or Expert level of proficiency in MS Excel.
• Possess strong analytical, organizational and communication skills, able to explain analysis results to technical and non-technical teams.
• Able to work in a fast‑paced, metric-driven environment, manage multiple priorities, meet deadlines, and respond to changing business needs.
• Excellent problem‑solving and critical‑thinking abilities.
• High attention to detail and accuracy.
• Strong collaboration skills with internal stakeholders.
• Ability to maintain patient confidentiality and comply with HIPAA regulations.

SALARY & BENEFITS:

• $130-160k annually plus bonus opportunity
• Medical, Dental, and Vision
• 401(k) with Company Match 
• Sick and Vacation Days 
• Flexible Spending Account 
• Life & Disability Insurance 
• Education Assistance
• Employee Referral Program

Career-minded individuals will find our business challenging and our reputation for excellence just one of the rewards we have to offer. To further enhance this tradition of excellence, our employees participate in continuous training and development programs in a variety of disciplines.

The posted range for this position is $130-160k which is the expected starting base salary range for an employee who is new to the role to fully proficient in the role. Many factors go into determining employee pay withing the posted range including education, prior experience, training, current skills, certifications, location/labor market, internal equity, etc.

At the time of this posting, this position is eligible for a bonus not reflected in the posted range subject to the achievement of the plan.

Shield Healthcare, Inc. is an Equal Employment Opportunity Employer and does not discriminate against applicants or employees on the basis of race, color, religion, creed, national origin, ancestry, disability that can be reasonably accommodated without undue hardship, sex, sexual orientation, gender identity, age, citizenship, marital or veteran status, or any other legally protected status.

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