Billing Director

We are a growing, mission-driven outpatient addiction treatment organization dedicated to helping individuals and families overcome substance use disorders and co-occurring mental health challenges. We specialize in comprehensive drug and alcohol recovery services through structured outpatient programs, including Partial Hospitalization (PHP), Intensive Outpatient (IOP), and traditional outpatient services. Our approach combines evidence-based clinical care with compassionate support in a comfortable, non-residential setting that allows clients to maintain connections to their families, jobs, and communities while receiving high-quality treatment. Headquartered in North Carolina with an expanding footprint across multiple states, we currently employ approximately 45-50 team members and are committed to clinical excellence, operational integrity, and long-term recovery outcomes.

We are seeking a knowledgeable and driven Billing Director to take ownership of our Medicaid and out-of-network billing operations. This is a high-impact leadership position within our 4-person billing department, responsible for ensuring maximum revenue capture, regulatory compliance, and efficient revenue cycle performance in a behavioral health and substance use treatment environment. The role offers significant autonomy and the opportunity to shape billing strategy, either by directly managing operations and building an internal team or by effectively overseeing our third-party out-of-network billing partner. This position is ideal for a hands-on billing professional who thrives in a growing organization and wants to play a key role in our continued expansion.

• Lead all Medicaid billing processes (network and out-of-network) across our multi-state operations.
• Manage and optimize performance of our third-party billing vendor handling out-of-network claims.
• Track and improve key revenue cycle metrics including days in A/R, denial rates, collection ratios, and first-pass claim acceptance.
• Collaborate with clinical, medical, and administrative teams to ensure accurate documentation, timely charge entry, and proper coding.
• Leverage our EMR and RCM platforms (experience with Kipu and/or Collaborate MD strongly preferred).
• Manage claim submissions, follow-up, appeals, payer relations, and reimbursement optimization with a primary focus on Medicaid.
• Develop billing workflows, policies, and internal controls to support scalability as the organization grows.
• Provide leadership, training, and mentorship to internal billing staff while maintaining strong coordination with external partners.
• Monitor regulatory changes, payer policies, and industry updates affecting behavioral health billing.
• Deliver regular performance reports and revenue forecasts to senior leadership.

• 3–7+ years of progressive medical billing experience with a strong emphasis on Medicaid billing (network and out-of-network) in healthcare, ideally in behavioral health or substance abuse treatment.
• Prior experience managing billing teams or third-party billing vendors is highly preferred.
• Hands-on proficiency with Kipu EMR and/or Collaborate MD RCM systems is a significant advantage.
• Deep knowledge of revenue cycle management, claim editing, denial management, appeals, and compliance requirements.
• Strong analytical skills with the ability to identify trends, solve problems, and drive process improvements.
• Excellent communication and collaboration skills.
• Must be based in or willing to work from one of our primary locations: Houston, TX, Atlanta, GA, or Wilmington, NC.

We are open to candidates across different experience levels — from seasoned directors ready to fully own and scale the function to strong Medicaid billing professionals who can effectively manage the third-party partner while growing into the broader director role.

We offer a competitive base salary in the $110,000 – $150,000 range, highly dependent on your level of Medicaid billing expertise, leadership experience, and overall value you bring to the role.

Candidates with deep experience in both network and out-of-network Medicaid billing, strong revenue cycle knowledge, and the ability to immediately lead and optimize operations (including managing third-party partners or building an internal team) can expect to be compensated at the higher end of the range. Professionals with solid billing experience who are ready to grow into a full director-level role will typically fall in the mid-range.

We also provide a basic benefits package. Please note that we do not currently offer a 401(k).

This is an excellent opportunity to join a purpose-driven organization where your billing expertise will directly support expanded access to life-changing addiction treatment services.