Billing Manager – Revenue Cycle Managed Services

This is a fully remote position, open to applicants in United States.

📋 Description

• Lead and enhance hospital and/or professional billing operations for a specific health system client.

• Provide operational guidance for claim generation, billing adjustments, claim corrections, claim submissions, payer and clearinghouse acceptance, and billing-related work queues.

• Take ownership of billing results, identify obstacles, drive issues to resolution, and ensure progress across teams and functions.

• Supervise daily billing operations and manage performance in accordance with contractual service level agreements.

• Collaborate directly with client leadership to address obstacles and enhance billing performance.

• Act as the primary operational leader for billing services provided to the assigned health system client.

• Foster relationships with Revenue Cycle, Finance, Patient Financial Services, and operational leaders.

• Conduct operational reviews focusing on performance, barriers, action plans, and opportunities for improvement.

• Oversee daily billing workflows, work queues, claim holds, edits, and pre-bill exceptions.

• Ensure timely and accurate claim submissions in compliance with payer and regulatory requirements.

• Address billing errors, clearinghouse rejections, payer front-end rejections, submission issues, corrected claims, and rebilling requirements.

• Identify recurring problems, assess root causes, and facilitate resolution across coding, revenue integrity, patient access, IT, and other teams.

• Maintain standardized billing workflows, procedures, and quality controls.

• Monitor unresolved billing inventory and ensure clear ownership and follow-through.

• Analyze billing performance metrics and implement corrective actions.

• Prepare and present operational performance and action plans to both client and internal leadership.

• Lead, mentor, and develop billing supervisors, team leads, and billing specialists, including both onshore and near-shore resources.

• Conduct performance evaluations, coaching sessions, and staff development planning.

• Assist in workforce planning, staffing, and resource allocation.

• Drive process enhancements addressing root causes and collaborate with technology, automation, and revenue cycle transformation teams.

• Support system conversions, workflow redesign, process standardization, client implementations, transitions, and service expansion initiatives.

• Ensure that improvements are implemented, measured, and sustained.

• Maintain compliance with HIPAA, regulatory requirements, payer guidelines, and organizational policies.

• Assist with billing audits and compliance reviews, ensuring adherence to billing controls, documentation, and quality monitoring.

⛳️ Requirements

• Bachelor’s degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field; equivalent experience may also be considered.

• Over 5 years of progressive healthcare revenue cycle experience with a focus on hospital billing operations.

• More than 2 years of leadership experience managing billing teams in a hospital, health system, business office, or revenue cycle outsourcing environment.

• Strong understanding of hospital and professional billing, claim generation, billing edits, clearinghouse workflows, claim submission requirements, claim rejections, corrected claims, and payer billing requirements.

• Experience in managing operational KPIs and developing performance improvement strategies.

• Practical experience with Epic Hospital Billing (HB) and/or Professional Billing (PB), including billing work queues, claim edits, claim submissions, and billing exception workflows.

• Ability to take charge of operational challenges, collaborate across functional boundaries, and drive issues to resolution.

• Capability to manage client relationships and lead cross-functional initiatives.

• Proficient with revenue cycle reporting tools, Microsoft Excel, and healthcare billing systems.

• Preferred: experience in supporting managed services, outsourcing, or complex health system billing operations.

• Preferred: knowledge of both acute care and ambulatory billing operations.

• Preferred: experience with both Epic Hospital Billing (HB) and Professional Billing (PB).

• Preferred: HFMA, CRCR, or other relevant revenue cycle certification.

• Preferred: experience in presenting operational performance, risks, and improvement strategies to client and executive leadership.

• Preferred: demonstrated success in enhancing billing workflows, productivity, quality, or claim performance.

🏝️ Benefits

• Annual performance bonus may be available for salaried positions.

• Additional benefits and perks may be provided, depending on the position and employment terms.

• Caring, fun, honest, and autonomous work environment.

• Commitment to diversity and inclusion; employees feel valued and empowered.