Medical Billing Manager

Job Description

Job Description

Billing Manager

Reports To: COO / Practice Administrator; coordinates with senior leadership on financial performance and departmental goals.

Job Summary

The Billing Manager is the primary driver of all revenue cycle operations for the practice. This is a hands-on, working manager role; not a supervisory role in title only. The person in this position is expected to personally execute the full scope of billing and credentialing functions on a daily basis while simultaneously building the systems, processes, and institutional knowledge needed to support future departmental growth.

Candidates should understand that this role is being structured intentionally: we are recruiting for the caliber of person who can grow into a department leader, while being fully prepared to roll up their sleeves and do the day-to-day work from day one. As the department expands, the Billing Manager will assume direct oversight of billing staff, providing guidance, training, and performance management to ensure a high-functioning team.

Duties and Responsibilities

Outward Facing & Patient Responsibilities

•        Communication

◦        Deliver clear, concise, timely, and professional communications with patients and visitors, both in person and by phone.

•        Capture Information

◦        Obtain and accurately document appropriate information from patients and visitors, including paperwork and financial information.

•        Process Information

◦        Process patient and visitor information in accordance with established procedures and protocols, including referrals and insurance verification.

•        Inform & Set Expectations

◦        Proactively inform patients and visitors of relevant processes, expected timelines, and outstanding requirements.

Inward Facing & Office Responsibilities

•        Professionalism & Team Leadership

◦        Model a positive, solutions-oriented attitude and serve as a steady, collaborative presence for the virtual assistant and cross-functional staff.

•        Communication

◦        Maintain clear and timely communications with practice staff regarding billing matters, policy changes, and departmental updates.

•        Prioritization & Workflow Management

◦        Evaluate and prioritize daily activities to ensure all critical billing functions are handled efficiently and on time.

•        Accuracy & Compliance

◦        Maintain the highest standard of accuracy in patient records and billing documentation, ensuring regulatory and payer compliance.

•        Environment

◦        Monitor and maintain all non-clinical work areas for organization, comfort, safety, and compliance.

Billing Operations Duties

The Billing Manager personally executes all billing functions. These are not oversight responsibilities; they are hands-on daily duties performed directly by the person in this role until such time as additional billing staff are hired.

•        Process superbills and associate charges into patient accounts.

•        Process and approve claims for submission to insurance carriers.

•        Review, address, and resolve rejected or invalid claim submissions.

•        Create and submit appeals; compile and send supporting medical records to insurance carriers.

•        Post insurance and patient payments; apply patient payments to accounts accurately.

•        Conduct accounts receivable follow-up to manage and reduce outstanding balances.

•        Process no-show fees and waiver requests in accordance with practice policy.

•        Answer all calls, emails, and voicemails directed to the billing department from patients, including balance inquiries, refund requests, itemized receipts, and lab billing questions.

•        Serve as a billing resource and escalation point for front desk staff.

•        Create procedure quotes and estimates for providers.

•        Review and respond to billing-related tasks submitted through the EMA system.

•        Process Corrona binders, queries, and related payments received through PaySpan and Instamed.

•        Run Stripe payments for Dermatology Link patients.

•        Collect, organize, and distribute mail to appropriate departments; enter payments received by mail.

•        Gather and process weekly deposits.

•        Scan received invoices and upload to Hubdoc.

•        Run reports for missed encounters and uncharged no-show fees.

•        Process medical records release forms and coordinate fee collections or patient portal access as needed.

•        Process insurance medical requests and audits.

•        Acquire and distribute uniforms.

Credentialing Duties

The Billing Manager personally manages all credentialing functions for the practice.

•        Provider Credentialing - Manage the end-to-end credentialing and re-credentialing process for all providers, including:

◦        Gathering and maintaining required credentialing documentation (licenses, DEA, malpractice, board certifications, etc.)

◦        Submitting and tracking credentialing applications with insurance carriers and credentialing bodies.

◦        Monitoring expiration dates and initiating renewals proactively.

◦        Maintaining organized, up-to-date credentialing files for each provider.

•        Insurance Credentialing - Coordinate enrollment and maintenance of practice and provider participation with insurance networks, including:

◦        Completing and submitting payer enrollment applications for new providers and practice locations.

◦        Communicating with payers to resolve enrollment issues and confirm effective dates.

◦        Monitoring payer contract status, fee schedules, and network participation agreements.

◦        Tracking and following up on pending credentialing applications to ensure timely completion.

Management & Leadership Duties

While there are currently no direct reports in the billing department, the Billing Manager is expected to lead with a management mindset from day one, building infrastructure, documenting processes, and preparing the department for future growth. When a Billing Specialist is added to the team, the following responsibilities will expand into active people management.

•        Process Oversight

◦        Monitor billing department workflows to identify inefficiencies and implement improvements.

•        Staff Development

◦        When the team grows, onboard, train, and develop billing staff, establishing clear performance expectations and providing ongoing feedback.

•        Escalation Management

◦        Serve as the primary escalation point for complex billing issues, payer disputes, and patient concerns; escalate matters to senior leadership as appropriate.

•        Task & Project Management

◦        Track, manage, and complete assigned departmental tasks and special projects; coordinate with leadership to ensure timely delivery.

•        Reporting

◦        Generate and present departmental reports on billing performance, A/R aging, claim denial trends, and credentialing status.

Expectations & Performance Measurements

Employees are expected to grow and develop their skills over time. The metrics below define the standards used to evaluate performance and effectiveness. The chart reflects minimum expectations for each title level, and the practice reserves the right to adjust these standards based on organizational needs. Titles are assigned based on overall performance and may be reviewed during 90-day and annual reviews or adjusted through disciplinary processes.

Qualifications

•        High school diploma / GED required; Associate's or Bachelor's degree in Healthcare Administration, Business, or related field preferred.

•        Minimum of two (2) years of medical billing experience required; dermatology experience strongly preferred.

•        Prior experience with provider and/or insurance credentialing preferred.

•        Demonstrated ability to independently manage a full billing workload without a team — candidates must be comfortable as a sole contributor.

Experience, Skills, and Abilities

•        Communication Skills

◦        Strong oral, written, and interpersonal communication skills; able to communicate clearly with patients, payers, providers, and staff.

•        Self-Directed Work Ethic

◦        Ability to independently manage a full daily billing workload with minimal supervision. Must be comfortable being the primary executor of all billing functions.

•        Leadership Aptitude

◦        Demonstrated ability to take initiative, work independently, and support or guide others; experience managing or mentoring staff a plus.

•        Tech Skills

◦        Proficiency with Windows PC, iPad, EMA or comparable EHR/PM systems, and standard office technology; minimum 40 wpm typing (50 wpm preferred).

•        Detail Management

◦        High attention to detail with strong follow-through on tasks, deadlines, and compliance requirements.

•        Organization

◦        Ability to manage multiple workflows, priorities, and projects simultaneously without loss of accuracy.

•        Problem Solving

◦        Demonstrated ability to analyze billing issues, identify root causes, and implement solutions; knows when to escalate.

•        Bilingual

◦        Fluency in English and Spanish preferred.

Health, Safety, and Compliance Commitment

•        Maintain knowledge of and comply with all applicable OSHA regulations.

•        Maintain knowledge of and comply with all applicable HIPAA regulations.

•        Adhere to all clinic safety, privacy, and confidentiality policies and procedures.

•        Report known or suspected workplace hazards to the Practice Manager promptly.

Working Conditions & Physical Demands

•        Extended periods of sitting while using office equipment and computers.

•        Some lifting of supplies and materials may be required.

•        Occasional walking to administrative offices or other areas of the clinic.

Environmental Conditions & Mental Demands

This position operates in a fast-paced clinical and administrative environment involving constant interaction with staff, patients, payers, and vendors by phone and in person. The Billing Manager must navigate competing priorities, time-sensitive deadlines, and unexpected issues with composure and sound judgment.

This role requires a high degree of adaptability. Because the Billing Manager is currently the sole billing employee, there is no one to catch what falls through the cracks; the individual in this role must be self-reliant, thorough, and disciplined in managing their workload. Tasks and priorities may shift based on practice needs, and the individual is expected to respond with professionalism and resourcefulness.

The practice is committed to supporting the growth and development of this role. As the organization expands and a Billing Specialist is added to the department, the Billing Manager will have the opportunity to grow into a true team leadership position. This is a role with a defined growth trajectory, and we are looking for someone who is excited by both the immediate hands-on work and the future opportunity to build and lead a team.