Director of Accounts Receivable

Job Description

We are seeking a Director of Accounts Receivable (AR) to take full ownership of our AR operations across all service lines. As we scale, our AR needs have grown more complex—requiring strategic oversight, operational excellence, and a strong understanding of California’s healthcare reimbursement landscape. Reporting directly to the CFO, this leader will streamline processes, improve efficiency, and ensure accurate billing and collections across multiple funding sources and entities.

This is a high-impact role with the opportunity to reshape our AR department, mentor a dedicated team, and implement best practices that support our continued expansion.

Key Responsibilities

• Lead all AR functions across multiple business lines, including Assisted Living, Recuperative Care, Home Health & Hospice (outsourced), and Behavioral Health.
• Own the end-to-end AR process, ensuring accuracy, timeliness, and compliance with payer requirements.
• Oversee AR team performance, working closely with the current AR Manager and billing staff; assess team structure and scale as needed.
• Streamline workflows and improve efficiency by identifying gaps in current processes and implementing best practices.
• Ensure effective revenue cycle operations for a variety of payer sources, particularly Medi-Cal and other state/county-funded programs.
• Act as the subject matter expert on state and county reimbursement models, especially Assisted Living Waivers and CalAIM.
• Provide oversight to outsourced billing vendors (e.g., OHG) and ensure alignment with internal standards.
• Collaborate cross-functionally with Finance, Operations, Compliance, and Clinical leadership to support growth initiatives.
• Monitor AR KPIs and aging reports, proactively addressing issues to optimize cash flow and minimize write-offs.
• Support billing for commercial payers (e.g., Blue Cross, Blue Shield) including understanding of pre-authorizations and payer contracts.
• Provide strategic input and operational readiness for new acquisitions and service line launches, including oversight of Horizon’s diverse revenue streams.

Qualifications

• 8+ years of progressive AR/revenue cycle experience in healthcare, with at least 3 years in a leadership or director-level role.
• Deep understanding of California state and county reimbursement programs (e.g., Medi-Cal, CalAIM, Assisted Living Waivers).
• Background in Skilled Nursing, Home Health, or Hospice is highly preferred—especially if experienced with non-Medicare billing models.
• Proven success in leading and developing AR teams, including outsourced vendor management.
• Experience optimizing AR workflows and implementing AR/billing systems or process improvements.
• Strong financial acumen with the ability to analyze AR metrics, reporting, and trends.
• Excellent communication skills with a collaborative, team-oriented mindset.
• Comfortable in a fast-paced, growth-oriented environment where not everything is perfect—but the team cares deeply and is motivated to improve.

Preferred Experience

• Familiarity with behavioral health reimbursement, including RCFE, ALF, or RTC models.
• Experience overseeing billing operations during multi-site acquisitions or rapid expansion.

Compensation: $160,000-$220,000 DOE