Medical Billing Manager-Family Practice

Job Summary:

We are looking for an experienced and detail-oriented Billing Manager to oversee all billing operations within our organization. The ideal candidate will have a strong background in healthcare billing, claims processing, and payer relationships, with the ability to manage a team, resolve complex billing issues, and optimize billing processes for maximum efficiency. As a Billing Manager, you will coordinate credentialing and recredentialing, ensure compliance with payer relationships and reporting standards, and ensure that our billing practices align with regulatory guidelines.

Key Responsibilities:Staff Management:

• Oversee the billing team, manage daily assignments, work hours, vacation time, and ensure timely and accurate completion of tasks.
• Audit staff work periodically to ensure adherence to billing processes and redistribute tasks to maintain efficiency.
• Manage Accounts Receivable (AR) reports, claim scrubbing, and collection activities, ensuring timely follow-up.

Billing and Claims Management:

• Review coding concerns for claims, educate staff, and resolve complex claim denials.
• Manage clearinghouse account and ensure smooth operation of electronic claim submissions (Waystar).

Credentialing and Recredentialing:

• Credential incoming medical providers with major payers (e.g., Medicare, Medicaid, Blue Cross, Aetna, Cigna, etc.).
• Oversee recredentialing processes for providers.

Payer Relations and Compliance:

• Collaborate with payer representatives to resolve complex payer issues and ensure correct fee schedules are followed.
• Present new coding opportunities and educate providers and billing staff on best practices.

MRA and HEDIS Management:

• Manage Medicare Advantage programs and distribute tasks to the billing team.
• Educate providers on bonus opportunities related to MRA and HEDIS results.

Payment and Financial Reporting:

• Monitor and track quarterly/yearly bonus payments from payers.
• Oversee biweekly bank deposits and ensure payments are accurately posted in the EMR system.
• Manage the yearly unclaimed property report.

Documentation and Audit:

• Review provider documentation for appropriate diagnoses and procedures.
• Periodically audit payer payments to ensure compliance with contractual agreements.

Operational Support:

• Coordinate supply orders.
• Oversee staff access to payer websites and ensure correct data management.

Process Optimization and IT Collaboration:

• Identify opportunities for automation to improve billing efficiency.
• Work with IT to implement software improvements and resolve technical issues.

Collaborative Efforts:

• Work closely with the Practice and Operations Manager to align billing operations with practice priorities.

Qualifications:

• Education: Bachelor’s degree in Accounting, Finance, Healthcare Administration, or related field (preferred). AAPC billing/coding certification (required).
• Knowledge: Strong understanding of coding, claims processing, payer relationships, and healthcare compliance standards.
• Technical Skills: Experience with major insurance payers (e.g., Medicare, Medicaid, Aetna, Cigna, Blue Cross) and EMR/billing software (e.g., Waystar, Availity, eClinicalWorks).
• Leadership: Strong leadership skills and experience managing teams.
• Analytical Skills: Ability to analyze complex billing data, resolve issues, and provide solutions.
• Communication: Excellent communication and organizational skills.
• Work Ethic: Ability to work independently and as part of a team in a fast-paced environment.

Work Environment:

• Full-time position with standard business hours.
• Occasional travel to satellite locations may be required for meetings, deposit pickups, and mail collection.

If you are looking for an opportunity to leverage your skills in a dynamic and collaborative environment, we encourage you to apply for this exciting position!

Job Type: Full-time

Pay: $45,000.00 - $60,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to Relocate:

• Saint Augustine, FL 32086: Relocate before starting work (Required)

Work Location: In person

Salary : $45,000 - $60,000