Billing Manager

Job Title: Billing Manager

Department: Billing

Travel Requirements

This role requires 10% travel for conferences, industry events, client engagements, departmental planning sessions, management meetings, training events or company retreat and events. All travel will be pre-approved.

Team Oversight & Departmental Operations

· Manage day-to-day activities of the billing team, including supervisors and specialists.

· Ensure adequate resources are allocated to meet department goals.

· Re-prioritize and re-assign duties to ensure all billing functions are handled timely and accurately.

· Communicate with employees regularly during individual and department meetings.

· Coach and support team members to meet departmental KPIs and performance expectations.

Revenue Cycle Management & Problem Resolution

· Oversee submission of claims, denial resolution, payment posting, and accounts receivable.

· Perform weekly reviews of claims, denials, payments, and AR to ensure accuracy and completeness.

· Assist in solving complex billing issues and guide team members to improve resolution processes.

· Monitor and analyze trends in billing performance; provide assessments and recommendations to leadership.

· Minimize revenue adjustments by proactively managing daily work queues and workflows.

Performance Monitoring & Reporting

· Develop and implement performance metrics across the billing department.

· Create monthly and quarterly departmental reports to assess whether KPIs are being met and identify improvement opportunities.

· Review productivity logs and squad logs for training completion and efficiency tracking.

· Conduct ongoing monitoring to ensure continuous improvement in process and outcomes.

Compliance, Technology & System Management

· Stay up to date on governmental reimbursement changes and payer guidelines; support strategic planning to accommodate policy shifts.

· Manage the EDI (Electronic Data Interchange) function to ensure effective electronic claims submission.

· Maximize EDI capabilities to support faster reimbursement and enhance cash flow.

· Ensure billing practices remain compliant with HIPAA, Medicare, and commercial insurance rules.

Cross-Departmental & Onboarding Support

· Collaborate with Sales and Operations to prepare for onboarding new clients.

· Participate in setup of PM systems, ShareFile folders, EDI enrollments, and fee schedules.

· Support internal process improvement efforts by providing expert input on billing functionality and setup.

Requirements

Qualifications:

· Bachelor’s degree in Business, Accounting, Healthcare Administration, or equivalent experience.

· 5–10 years of experience in medical billing, with 3–5 years in a supervisory role.

· Proven experience in healthcare revenue cycle management, including denial management and AR recovery.

· Experience with Home Health and Hospice billing strongly preferred.

· Strong understanding of payer-specific and governmental billing requirements.

· Proficiency in billing software, clearinghouses, and data tools such as Excel and EMR/EHR platforms.

Benefits

• 401k matching
  
• Medical
  
• Dental
  
• Vision
  
• Paid time off
  
• Paid holidays