Position Overview: Reporting to and working with the Director of Billing, the Billing Manager role is responsible for the oversight of all functions related to the billing operations of 50-60 clients. This includes managing a team of 12-15 employees ensuring the accurate capture of all revenue, clean claims submissions both electronically or via mail, the management of Clearing House rejections, creating and administering ongoing training to staff, and upholding the integrity of the organization. Must have Orthopedic/ Pain Management/ Ambulatory Surgery Center billing experience and be COC, CPC, or CASCC Certified.

Responsibilities: 

• Implementation and oversight of best practices relating to quality assurance outcomes for both internal processes and external vendor processes.
• Oversight for billing specifications for all client payers in assigned region, which includes communication of specifications to staff, training on requirements, and provision of tools and resources.
• Routine audits of claim submissions sent electronically and via paper with the appropriate attachments.
• Assist when needed for charge entry, pulling operative notes, claims transmission and working claim rejections.
• Assist in developing new Tools to streamline processes.
• Coordinate coverage when needed to keep region current.
• Manage a team of 12-15 employees.
• Provides feedback and proposes changes or enhancements to billing policies and procedures.
• Provide ongoing training to improve overall performance of Billing Specialist.
• Performs other job-related duties as assigned.

Requirements (Skills, qualifications and education):

• COC, CPC, or CASCC certified Preferred - Candidate’s without a Certifications will be required to become certified within one year of employment.
• At least 2-5 years of medical billing experience. Orthopedic/Pain management/ Ambulatory Surgery Center billing experience is highly preferred.
• Proficiency in MS Word and Excel a must. Experience with Vision, AdvantX and/ or Waystar is helpful.
• Sound judgment and strong skills with respect to interpersonal relations, critical thinking, problem solving and analysis.
• The ability to communicate effectively, both verbally and in writing, with internal and external clients.
• Be able to multi-task and handle competing priorities while meeting or exceeding deadlines.
• Ability to work independently and as a member of the team with the ability to identify and resolve complex client problems.
• Must possess positive attitude to enhance a cooperative and energetic work environment.
• Excellent knowledge of health care billing procedures, documentation, regulations, payment cycles and standards.
• Candidate must be meeting or exceeding the expectations of their current role and be in good standing.
• Reasoning ability.
• The ability to communicate effectively, both verbally and in writing, with internal and external clients.
• High School Diploma or equivalent.