Billing Manager

Billing Operations ManagerOversee day-to-day billing operations for research/clinical trials, transplant services, and client/corporate billing portfolios across HB and PB. Ensure accurate, compliant, and timely claim production and sponsor/client invoicing; minimize billing-driven denials and avoidable write-offs; accelerate cash and improve billing quality through standardized workflows, controls, and cross-functional collaboration.QualificationsEducation: Associate degree in Healthcare Administration, Healthcare Management, or a related field highly preferred.Experience: Minimum of 3 to 4 years of progressive revenue cycle experience, including at least 1 to 2 years in billing operations (HB and/or PB) within a hospital or multi-site health system with a two-year degree.• Minimum of 3 years of supervisory experience in hospital and/or professional billing operations.• A formal degree may be substituted with 6+ years of direct, hands-on revenue cycle and supervisory experience.• Demonstrated experience with Epic and revenue cycle technologies.• Proven success leading teams through organizational change and process improvement initiatives.• License/Certification/Registration: Not required.• Deep expertise in:Hospital Billing (HB) and Professional Billing (PB)Research billing operationsTransplant billing processesClient and corporate billing environments• Working knowledge of:HIPAA compliance and privacy requirementsResearch billing audit practicesClinical trial billing regulationsTransplant billing regulatory requirements• Thorough understanding of:CMS and commercial payer billing regulationsUB-04 and CMS-1500 claim formsNCCI editsMedically Unlikely Edits (MUEs)Local Coverage Determinations (LCDs)National Coverage Determinations (NCDs)Timely filing requirements and specialty case implications• Research billing expertise, including:Sponsor billingStudy budget managementBilling gridsClinical trial complianceInvestigational charge captureSponsor invoicing and reconciliation• Transplant billing expertise, including:Organ acquisition cost accountingDRG and bundling methodologiesTransplant modifiersCoordination with Organ Procurement Organizations (OPOs)• Client and corporate billing proficiency, including:Contract invoicingThird-party billingDepartmental billingSpecial program billingStatement generation and reconciliation processes• Strong ability to interpret and reconcile:Sponsor agreementsPayer coverage determinationsInstitutional billing policiesBilling responsibilities to prevent duplicate billing and ensure compliance• Demonstrated change leadership and continuous improvement mindset, including experience implementing:Standardized playbooksWorkflow optimization initiativesAutomation solutions• Excellent written and verbal communication skills.• Strong cross-functional collaboration skills with the ability to work effectively across operational, clinical, research, financial, and compliance teams.• Technical proficiency with:Epic and revenue cycle management (RCM) systemsResearch billing modulesWork queue configurationReporting and analytics toolsElectronic sponsor invoicing platforms.