Billing Manager

This is a fully remote position, open to applicants in Arizona, +26 more states.

📋 Description

• Direct and manage daily billing operations, ensuring that patient encounters, drug charges, and administrative charges are captured, coded, and billed accurately, compliantly, and in a timely manner.

• Lead, develop, and hold billing specialists accountable to achieve departmental objectives.

• Supervise charge review and entry, charge reconciliation, claim submission, and management of claim rejections and denials.

• Submit electronic 837P and paper CMS-1500 claims within 24 hours or less of the service date.

• Ensure precise billing for infusion services, including drug HCPCS J-codes, NDC, units, wastage, JW/JZ modifiers, and drug administration CPT codes.

• Oversee billing-system edits, claim rules, automated workflows, testing, and ongoing monitoring.

• Manage clearinghouse edits, front-end rejections, payer acknowledgment reports, corrections, and resubmissions.

• Monitor and report on billing SMGs, including time to bill, clean claim rate, first-pass resolution rate, and rejection and denial rates.

• Lead month-end closing activities and reporting.

• Analyze trends in rejections and denials, implementing corrective actions as necessary.

• Collaborate with coding and compliance on CPT, HCPCS, ICD-10-CM, modifiers, documentation, and provider education.

• Establish SMGs, standards for productivity and quality, workload assignments, billing policies, procedures, and workflows.

• Act as the primary billing contact for new practice management and clearinghouse systems and programs.

• Work together with Operations, Patient Access, Coding, Credentialing, Payor Contracting, Finance, and Patient Resource Operations.

• Maintain current knowledge of payer policies, reimbursement methodologies, CMS guidelines, HIPAA, and state and federal billing regulations; support audits as needed.

• Train, coach, evaluate, supervise, motivate, and discipline members of the billing team.

• Conduct team meetings, account audits, productivity and quality reviews, cross-functional training, and succession planning.

• Ensure appropriate staffing levels and balanced workloads.

• Undertake special projects and other assigned responsibilities.

⛳️ Requirements

• High school diploma or equivalent is required.

• Professional certification is preferred, such as Certified Professional Biller (CPB), Certified Professional Coder (CPC), Certified Revenue Cycle Representative (CRCR), or Certified Medical Reimbursement Specialist (CMRS).

• At least 3 years of healthcare billing experience is required, preferably in an infusion center or multi-specialty physician practice (CMS-1500 billing).

• A minimum of 2 years of supervisory or management experience in a healthcare environment.

• Advanced understanding of medical billing, medical insurance, accounting, HIPAA, Medicare/Medicaid, CPT, HCPCS, and ICD-10.

• Experience in mentoring, coaching, and developing team members.

• Exceptional listening and influencing abilities.

• Proven attention to detail, strong analytical skills, critical thinking, problem-solving capabilities, and effective time management.

• Excellent interpersonal and communication skills.

• Demonstrated collaborative management style and a strategic outlook.

• Intermediate proficiency with all Microsoft Office applications.

• Prior experience handling sensitive and confidential information.

• Minimal travel may be required.

• Must reside in one of the specified states at the time of employment.

• Proof of eligibility to work in the US is necessary.

🏝️ Benefits

• Bonus Plan Target: 10% Annually (Based on performance).

• Private Equity for the Greater Good - Company-wide Employee Ownership Program.

• Medical, Dental, Vision coverage.

• Health Savings Account (HSA) with Employer Contribution.

• Touchcare - Insurance Concierge Service.

• 401K with a match of up to 4%.

• Paid Time Off (PTO): Accrual of 3 or more weeks.

• PTO Rollover and PTO Donation Program.

• Wellness Reimbursement Program - $360 Annually.

• Employee Referral Bonus - Uncapped Bonus Potential.

• Tuition Assistance Program & Professional Association Reimbursement.

• Employee Assistance Program (Provided by the Employer).

• Short & long-term disability coverage (Provided by the Employer).

• Life Insurance (Provided by the Employer).

• Remote work opportunities from a home office.

• Opportunities for growth and advancement.

• Competitive benefits.