Billing Manager

Job Description

Job Description

We are seeking an experienced Billing Manager to oversee day-to-day billing and Accounts Receivable operations within a healthcare environment. This position will manage billing workflows, collections, denial resolution, and payment posting while providing leadership and guidance to billing staff.

The ideal candidate will have strong healthcare billing and AR experience, a solid understanding of payer requirements, and prior experience leading or supervising a billing team. Experience with Pennsylvania healthcare billing, particularly within home health or behavioral health, is highly preferred.

Key Responsibilities

Billing & Accounts Receivable Management

• Oversee daily billing and AR operations to ensure accurate and timely claim submission, payment posting, and collections.
• Monitor AR aging and collection activity, with a focus on balances under 180 days as well as escalated aged receivables.
• Review account discrepancies and assist with complex billing or collection issues.
• Establish priorities for outstanding receivables and ensure appropriate follow-up.
• Monitor billing accuracy and identify opportunities to improve cash flow and reduce outstanding balances.

Denial Management

• Oversee the identification, tracking, and resolution of claim denials.
• Work with the billing team to address payer-specific requirements and recurring denial issues.
• Review denial trends and implement corrective actions to reduce future denials.
• Assist with escalated payer issues involving Medicare, Medicaid, BCBS, UHC, Aetna, and other insurance providers.

Team Leadership

• Provide day-to-day leadership and direction to billing and AR staff.
• Assign workloads, monitor productivity, and ensure billing and collection priorities are met.
• Train and mentor team members on billing procedures, payer requirements, and internal processes.
• Serve as an escalation point for complex billing, collection, and denial issues.
• Support management with staffing, training, and ongoing development of the billing function.

Billing Operations & Compliance

• Ensure claims are submitted accurately through electronic billing portals such as Availity, PEAR, and Magellan.
• Oversee insurance verification and authorization processes related to billing.
• Ensure billing activities follow HIPAA requirements and applicable healthcare regulations.
• Maintain accurate documentation and support internal and external billing audits.

Reporting & Process Improvement

• Prepare and review AR aging, collection, denial, and billing performance reports.
• Provide regular updates to Finance leadership regarding outstanding receivables, collection activity, and billing issues.
• Identify trends, workflow gaps, and opportunities to improve billing efficiency.
• Develop and maintain consistent billing procedures and internal controls.
• Partner with Payroll, Finance, and operational teams to resolve billing discrepancies and improve processes.

Qualifications

• Experience: 5+ years of healthcare billing and Accounts Receivable experience, including experience leading, supervising, or mentoring billing staff.
• Healthcare Background: Experience within home health, behavioral health, or a similar healthcare environment preferred.
• Location Knowledge: Familiarity with Pennsylvania healthcare billing practices and payer requirements is strongly preferred.
• Payer Experience: Working knowledge of Medicare, Medicaid, BCBS, UHC, Aetna, and other commercial payers.
• Technical Skills: Experience with billing systems such as Waystar, CPR+, QuickBooks, or Credible, along with Microsoft Excel and electronic claims portals.
• Education: Associate degree required; bachelor’s degree in Finance, Accounting, Healthcare Administration, Business, or a related field preferred.
• Leadership Skills: Ability to manage priorities, coach employees, resolve escalated issues, and maintain accountability across a billing team.
• Communication: Strong interpersonal and communication skills with the ability to work effectively across Finance, Payroll, and operational teams.
• Analytical Skills: Strong attention to detail with the ability to analyze AR trends, identify billing issues, and implement practical solutions.

Medical, dental, and vision insurance are available to qualified candidates who meet eligibility requirements.