Billing Manager

The Billing Manager is responsible for overseeing the claims department and ensuring that all claims are handled in a timely, accurate, and cost-effective manner. This role involves reviewing complex claims, improving claims processing workflows, and maintaining compliance with legal and regulatory standards. The Billing Manager also ensures customer satisfaction through effective communication and dispute resolution.

• Oversee the end-to-end claims process, from initial claim filing to settlement.
• Develop and implement procedures to improve efficiency and accuracy in claims

handling.

• Ensure compliance with internal policies, legal requirements, and industry regulations.
• Investigate complex claims, including reviewing documentation, and collaborating with legal and medical professionals when necessary.
• Manages front end and back end of the billing operations.

• Oversees the Billing Department by setting performance goals, monitor employee

performance, and provide feedback.

• Works with Partners and Clinic Directors to monitor progress on billing claims.
• Coordinates with Regional Office Manager on front desk operations.
• Conduct regular training sessions to keep the team up to date with industry best practices and new regulations.
• Oversees department’s daily activities and tasks, policies and procedures, staffing and resources (levels and effectiveness) and reporting requirements.

• Review claim documentation and assessments to ensure accurate and fair settlements.
• Collaborate with legal, medical, and other professionals to resolve disputes and facilitate settlements.

• Analyze claims data to identify trends, risks, and areas for improvement.
• Generate reports on claims performance, department productivity, and costs for senior management.
• Use data insights to recommend process improvements and cost-reduction strategies.

• Works on special projects as determined by business needs and requires strong

independent work ethic.

• Reviews and research accounts to identify errors with claims, takes the required actions including following up with the pertinent personnel to obtain the required information to address and resolve the identified issues.
• Ensures corrected claims are created and sent to the payer in a timely fashion.
• Reviews account information and able to explain charges and other related inquiries

related to the special project while complying with HIPAA guidelines.

• Document all actions in all systems according to policy.
• Maintain courteous and cooperative working relationships with all levels of management, employees, patients and guarantors.
• Oversees data within EMR System.
• Endures billing success to insurances and patient billing success.
• Perform other duties as assigned.

• 3 years or more of medical billing/collections experience
• Management and supervisory experience
• Experience in data management working with spreadsheets and PC literate
• Well organized and detail oriented; ability to effectively manage multiple tasks and

deadlines

• Effective and comfortable communicator
• Flexible and positive attitude and high level of comfort in a dynamic and changing

environment

• Strong sense of job ownership
• Ability to take initiative and work well with minimal supervision
• Good problem-solver and trouble-shooter
• Experience with business correspondence.
• Excellent communication skills are necessary to accomplish job duties.