Billing Manager

Job Type: Full-Time (This is not a remote position) 

Reports To: Practice Administrator

Job Summary:

The Billing Manager is responsible for overseeing the revenue cycle operations for a multi-specialty medical facility specializing in Minimally Invasive Surgery, Advanced Spine Surgery, Pain Management, Radiology, and Physical Therapy. This role ensures accurate and timely billing, coding compliance, claims processing, and collections while optimizing reimbursement and maintaining regulatory compliance. The Billing Manager will lead a team of billing professionals, monitor financial performance, and implement strategies to improve efficiency and revenue recovery.

Key Responsibilities:

Revenue Cycle & Billing Management:

• Oversee the entire billing and collections process to maximize revenue and minimize outstanding accounts receivable.
• Ensure accurate and timely claims submission to Medicare, Medicaid, commercial insurers, and workers' compensation payers.
• Identify and resolve denials, rejections, and underpayments, ensuring timely appeals and reimbursement.
• Implement best practices to optimize billing workflows and reduce claim errors.
• Ensure compliance with payer policies, state and federal regulations, and HIPAA guidelines.

Coding & Compliance:

• Oversee the accuracy of ICD-10, CPT, HCPCS, and modifier coding for surgical, pain management, radiology, and therapy procedures.
• Ensure compliance with Medicare, Medicaid, and commercial insurance requirements.
• Work closely with providers and coders to ensure correct documentation and coding, reducing claim rejections.
• Conduct internal audits to ensure compliance with billing regulations and best practices.

Staff Leadership & Training:

• Lead and mentor a team of billing specialists, coders, and accounts receivable staff.
• Provide ongoing training and education on coding updates, payer policies, and revenue cycle management strategies.
• Foster a collaborative work environment, ensuring a high level of staff performance and accountability.

Financial Oversight & Reporting:

• Monitor key performance indicators (KPIs), including days in A/R, denial rates, and collection efficiency.
• Generate and analyze weekly, monthly, and quarterly financial reports to track revenue cycle performance.
• Collaborate with leadership to develop strategies for financial growth and operational improvements.
• Assist in contract negotiations with payers to optimize reimbursement rates.