Billing Manager

Billing Manager

The Billing Manager, Ancillary Services is accountable for overseeing end-to-end billing operations across ancillary service lines, which may include diagnostic imaging, laboratory, therapy, pharmacy, home health, and other supplemental services. This role ensures the timely and accurate submission of claims, effective denial management, coding and billing compliance, and adherence to payer contracts, regulatory requirements, and organizational policies.

The Billing Manager leads and develops the billing team while driving operational efficiency, clean claim performance, and revenue cycle outcomes. Working cross-functionally with Operations, Finance, Compliance, and other key stakeholders, this position identifies billing trends and process improvement opportunities, resolves escalated issues, and implements strategies that support accurate reimbursement, optimized revenue performance, and organizational financial goals.

Revenue Cycle & Billing Operations

The Billing Manager oversees the full billing cycle from charge capture through payment posting and reconciliation. This includes managing claim submission processes, verifying patient insurance information, monitoring accounts receivable aging, and ensuring timely follow-up on unpaid or denied claims. Credit management — the process of minimizing risk and ensuring payment — requires a combination of financial expertise, communication skills, and a strong understanding of industry trends and regulations. The manager is also responsible for tracking and analyzing financial statements to assess billing performance against organizational benchmarks.

Compliance & Regulatory Oversight

The Billing Manager ensures all billing activities align with applicable payer guidelines, federal and state regulations, and internal policies. This encompasses compliance management, monitoring and assessing systems to ensure they adhere to industry and regulatory standards and conducting regular audits to implement corrective measures where needed. Compliance with coding standards such as ICD-10-CM and CPT codes, as well as AHIMA Standards of Ethical Coding, ensures the accuracy, integrity, and confidentiality of billing records. Compliance reporting, documenting evidence of adherence to regulatory frameworks is a core accountability of this role.

Team Leadership & People Management

The Billing Manager leads, coaches, and develops a team of billing specialists and coordinators. This means defining roles and responsibilities clearly for team members, monitoring performance, and providing constructive, timely feedback. This role requires motivating and empowering others by inspiring enthusiasm and keeping the team focused on goals, while providing the resources and autonomy for individuals to accomplish their work. The manager is also expected to support and coach others by encouraging development opportunities and identifying team members' strengths and potential.

Financial Performance & Reporting

The Billing Manager is responsible for tracking key performance indicators (KPIs) including clean claim rates, denial rates, days in accounts receivable, and net collection rates. Operating cost management, the process of controlling and reducing expenses while ensuring operational efficiency is a key component of this accountability. The role prepares and presents regular financial reports to leadership, with recommendations for billing process improvements that enhance profitability and sustainability.

Payer Contracting & Vendor Relations

The Billing Manager maintains working knowledge of payer contracts across commercial, Medicare, Medicaid, and managed care plans relevant to ancillary services. They manage operational-level agreements with vendors and third-party billing partners, clarifying roles, responsibilities, and deliverables to ensure services are delivered efficiently and effectively. Regulatory requirements management, including understanding and adhering to regulatory changes and monitoring updates is essential to this function.

Required Qualifications

Education

• Bachelor's degree in health information management, Business Administration, Finance, Accounting, or a related field (or equivalent combination of education and experience)
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or similar certification preferred

Experience

• 3–7 years of progressive experience in medical billing, revenue cycle management, or healthcare financial operations
• Minimum 2 years in a supervisory or management capacity
• Demonstrated experience managing billing for ancillary service lines (e.g., lab, radiology, therapy, pharmacy, home health, or durable medical equipment)

Technical Skills

• Billing and Invoicing: Proficiency in financial quotes, charge capture, claim submission workflows, and invoicing systems
• Credit Management: Ability to assess and monitor outstanding balances, set payment terms, and manage collection processes
• Financial Reporting: Skill in preparing and analyzing standardized financial documents to assess organizational financial health
• Compliance Management & Reporting: Knowledge of regulatory frameworks and the ability to document compliance evidence systematically
• Operating Expense Management: Understanding of cost controls, budgeting, and operational efficiency to improve financial performance
• Financial Risk Management: Ability to identify, assess, and mitigate financial risks associated with billing operations and payer variability
• EHR/Practice Management Systems: Experience with billing platforms (e.g., Epic, Athenahealth, eClinicalWorks, or similar)
• Regulatory Requirements: Deep understanding of payer regulations, HIPAA, and federal/state coding and billing rules

Behavioral Competencies

Deciding and Initiating Action: Makes confident, well-informed decisions without unnecessary delay, including under time pressure and in ambiguous situations. Takes accountability when things go wrong.

Leading and Supervising: Clearly defines team roles and responsibilities, monitors performance, distributes workload appropriately, and directly addresses performance gaps.

Working with People: Listens attentively to stakeholders, recognizes team contributions, encourages diversity and inclusion, and demonstrates empathy and courtesy in all interactions.

Upholding Ethics and Values: Acts consistently in accordance with ethical standards, upholds integrity despite external pressure, and ensures billing practices meet both legal and organizational standards.

Skills - Descriptions

Leadership - Leads by example, sets clear expectations, holds team members accountable, and provides coaching and guidance to support individual and team success.

Analytical Skills - Evaluates billing data, identifies trends and root causes, and uses findings to make informed decisions and improve revenue cycle performance.

Attention to Detail - Maintains a high level of accuracy when reviewing claims, billing records, financial data, coding information, and compliance requirements.

Problem Solving - Identifies billing and operational issues, evaluates potential causes and solutions, and takes appropriate action to resolve problems and prevent recurrence.

Communication - Communicates clearly and professionally with team members, leadership, payers, vendors, and cross-functional partners regarding billing issues, expectations, and outcomes.

Organization & Prioritization - Effectively manages competing priorities, deadlines, escalations, and team responsibilities while ensuring critical billing activities are completed timely.

Collaboration - Builds effective working relationships across departments and works collaboratively with Finance, Operations, Compliance, and other stakeholders to achieve shared objectives.

Accountability - Takes ownership of billing performance, team results, deadlines, and assigned responsibilities and follows through on commitments and corrective actions.

Adaptability - Adjusts effectively to changes in payer requirements, regulations, systems, organizational priorities, and operational needs.

Process Improvement - Identifies opportunities to improve workflows, reduce errors and denials, increase efficiency, and strengthen billing and revenue cycle processes.

Professionalism - Demonstrates integrity, discretion, sound judgment, and professionalism when handling sensitive financial, employee, and healthcare information.

Work Environment & Physical Requirements

• In office position
• Ability to sit at a workstation for extended periods

Compensation & Benefits

• Competitive salary based on experience
• Health, dental, and vision insurance
• 401(k) with company match
• Paid time off, holidays

Diversity, Equity & Inclusion Statement

MTI America is proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.