Medical Billing Manager
Job Description
REQUIREMENTS
- Minimum of 10 years of medical billing and revenue cycle experience, preferably within ASC, pain management, orthopedic, spine, and multi-specialty healthcare environments.
- Strong working knowledge of insurance billing processes, claims management, denial resolution, appeals, payment posting, and accounts receivable follow-up.
- Experience managing complex billing operations involving commercial insurance, Medicare, Medicaid, workers compensation, and out-of-network billing.
- Thorough understanding of healthcare billing regulations, payer requirements, and No Surprises Act compliance.
- Hands-on experience using Tebra and eClinicalWorks (eCW) within a multi-provider or multi-specialty practice environment.
- Strong understanding of ASC billing workflows, surgical billing processes, and specialty procedure reimbursement.
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding certification strongly preferred.
- Working knowledge of CPT, ICD-10, HCPCS, modifier usage, and medical coding compliance standards.
- Experience identifying and resolving billing discrepancies, underpayments, payer issues, and reimbursement challenges.
- Ability to analyze billing data, monitor KPIs, identify trends, and implement operational improvements that increase collections and reduce denials.
- Excellent organizational skills with the ability to manage multiple priorities, deadlines, and workflows in a fully remote environment.
- Strong communication and problem-solving skills with the ability to collaborate effectively across clinical, operational, and leadership teams.
- Leadership experience supporting, mentoring, or guiding billing team members in a professional and accountable manner.
- High level of accuracy, attention to detail, professionalism, and confidentiality when handling sensitive patient and financial information.
- Proficient in Microsoft Office, including Excel reporting and spreadsheet management.
- Self-motivated, dependable, and capable of working independently with minimal supervision in a remote setting.
RESPONSIBILITIES
- Oversee daily billing and revenue cycle operations across multiple specialties including ASC, pain management, orthopedic, spine, and neuromonitoring services.
- Manage insurance claim submission, payment posting, denial management, appeals, collections, and accounts receivable follow-up to ensure timely and accurate reimbursement.
- Monitor and improve key revenue cycle metrics including claim acceptance rates, denial trends, AR aging, collections performance, and reimbursement turnaround times.
- Ensure compliance with payer guidelines, federal and state billing regulations, and No Surprises Act requirements.
- Review and resolve complex billing issues, claim denials, underpayments, and payer escalations while identifying root causes and implementing corrective actions.
- Maintain strong working knowledge of commercial insurance, Medicare, Medicaid, workers compensation, and out-of-network billing processes.
- Collaborate with providers, clinical staff, operations, and leadership teams to improve billing accuracy, workflow efficiency, and revenue cycle performance.
- Develop, implement, and maintain billing policies, procedures, and standard operating processes to support scalability and operational consistency.
- Train, mentor, and support billing staff while promoting accountability, professionalism, and continuous process improvement within a remote work environment.
- Identify opportunities for workflow automation, operational efficiencies, and process improvements to reduce denials and optimize collections.
- Prepare and present regular reporting related to billing performance, payer trends, collections activity, and operational KPIs.
- Stay current on payer updates, industry regulations, coding changes, and healthcare billing best practices impacting ASC and specialty billing operations.
- Support audits, credentialing coordination, documentation reviews, and payer-related requests as needed.
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