Medical Billing Manager

Position SummaryThe Medical Billing Manager is responsible for overseeing the day-to-day operations of the billing department, ensuring the accurate and timely submission of claims, optimal reimbursement, and full compliance with applicable regulations. This role is critical to the financial performance of the practice and requires in-depth experience with out-of-network billing, no-fault, and workers’ compensation claims—especially in the context of orthopedic and pain management services.

Key ResponsibilitiesBilling OperationsManage the full billing cycle from charge entry and claim submission to payment posting and denial managementLead the billing process for out-of-network, no-fault, and workers’ compensation claims with an expert understanding of their complexities and unique documentation requirementsMonitor and maintain performance metrics including days in A/R, claim denial rates, and collectionsReview EOBs, denials, and payer communications to ensure timely appeals and maximize revenue captureOversee patient statements, payment plans, and financial counseling in coordination with the front desk and finance teamsCompliance and DocumentationEnsure billing practices comply with federal/state regulations, HIPAA, and payer policiesMaintain up-to-date knowledge of ICD-10, CPT, and HCPCS codes, particularly as they relate to orthopedic and pain management proceduresImplement and monitor internal controls and billing audits to mitigate risks and ensure accuracyLeadership and Team ManagementSupervise, train, and evaluate billing team members to ensure optimal performance and adherence to best practicesAssign workloads, track productivity, and provide coaching for performance improvementFacilitate ongoing education to adapt to payer changes and regulatory updatesCross-Department CollaborationWork closely with physicians, clinical staff, and administrative leaders to ensure correct documentation and codingAct as the primary point of escalation for complex billing issues, both internally and with external vendors or payersReporting and AnalysisGenerate monthly and ad-hoc reports on collections, aging, write-offs, and other key billing metricsProvide insights and recommendations to leadership based on data analysis and industry trendsSupport budgeting and forecasting with reliable revenue cycle inputsRequired QualificationsExperience:

3–5 years of progressive experience in medical billing, with at least 2 years in a supervisory or management capacityPreferred experience in out-of-network billing, no-fault, workers' compensation, and orthopedic or pain management practicesTechnical Skills: Proficient with EMR/EHR and billing software and Microsoft Office SuiteDesired Skills And CompetenciesIn-depth knowledge of insurance guidelines (including Medicare, Medicaid, and commercial payers)Strong problem-solving and organizational skillsExcellent written and verbal communication abilitiesAbility to work independently and collaboratively in a fast-paced clinical environmentProven track record of improving billing workflows and increasing reimbursement efficiencyPowered by JazzHRk26OC3MOol