Billing Manager

Job Description

Job Description

We're looking for an experienced, detail-oriented Billing Manager to lead our billing operations and drive timely, accurate, and compliant reimbursement across all services we provide. This is a hands-on leadership role for someone who knows how to run a high-performing billing department — improving revenue cycle performance, reducing claim denials, accelerating cash collections, and keeping us compliant with Medicaid, Medicare, and other payer requirements.

You'll manage billing staff, set operational standards, streamline workflows, track key performance metrics, and partner closely with Finance, Clinical Operations, and Accounts Receivable to maximize reimbursement while protecting revenue integrity.

Billing Operations

• Lead day-to-day operations of the Billing Department

• Supervise, coach, and develop a team of billing specialists

• Ensure timely, accurate submission of electronic and paper claims

• Oversee claim edits, reconciliation, payment posting coordination, and QA

• Build and maintain SOPs for billing operations

• Monitor productivity and resolve workflow bottlenecks

Revenue Cycle Management

• Ensure accurate billing/reimbursement across Medicaid, Medicare, MCOs, and commercial payers

• Track claim status and drive prompt follow-up on unpaid claims

• Reduce denials through proactive quality reviews and staff training

• Partner with Accounts Receivable to improve collections and reduce aging

• Spot reimbursement trends and recommend corrective action

• Validate billing accuracy before claim submission

Compliance & Regulatory Oversight

• Ensure compliance with federal, state, Medicaid, Medicare, HIPAA, and payer regulations

• Stay current on reimbursement policies and billing guidelines

• Support payer audits, ADRs, and reimbursement appeals

• Confirm documentation supports billed services

• Help implement billing compliance initiatives and internal controls

Reporting & Performance

• Build billing performance dashboards and management reports

• Monitor clean claim rate, first-pass acceptance rate, denial rate, days in A/R, turnaround time, collection rate, and outstanding receivables

• Analyze trends and recommend process improvements

• Provide regular updates to the CFO

Process Improvement

• Streamline billing workflows and drive efficiency

• Collaborate with Finance and IT on billing systems and automation

• Support system upgrades and software implementations

• Build corrective action plans for recurring issues

Days 1–30: Assess current workflows, staffing, and compliance; deliver an initial Billing Operations Assessment to the CFO

Days 31–60: Standardize procedures, implement QA reviews, improve first-pass acceptance, launch performance dashboards

Days 61–90: Improve turnaround times, reduce denials, launch KPI reporting, roll out staff training and long-term recommendations

Required

• Bachelor's degree in Healthcare Administration, Business Administration, Accounting, Finance, or related field

• 5+ years of healthcare billing experience

• 3+ years of supervisory or management experience

• Strong knowledge of Medicaid and Medicare billing regulations

• Experience with EMR and billing software

• Strong analytical, organizational, and leadership skills

• Excellent communication and problem-solving abilities

• Proficiency in Microsoft Excel and reporting tools

Preferred

• Certified Professional Biller (CPB) or equivalent certification

• Home Health or Hospice billing experience

• Experience managing payer audits and ADRs

• Knowledge of reimbursement methodologies and fee schedules

• Track record implementing billing process or revenue cycle improvements

• Familiarity with multi-site healthcare operations

• Competitive executive salary

• Medical insurance

• Paid time off / holidays