Billing Manager

Position Summary :

The Billing Manager will play a pivotal role in overseeing the transition of our billing operations from a third-party billing company to an in-house billing department. This position will manage all aspects of the billing cycle for a busy medical pain clinic specializing in pain management. The Billing Manager will ensure seamless billing processes, compliance with insurance requirements, and optimal revenue collection using the clinic's eClinicalWorks EHR and Waystar Clearinghouse systems.

Key Responsibilities :

Billing Transition Management :

• Oversee and coordinate the transition of billing operations from the current third-party billing company to an in-house team.
• Develop and implement workflows and policies to streamline in-house billing processes.
• Train staff on new billing procedures and systems.

Billing Operations :

• Manage all aspects of the billing cycle, including :

Insurance collections

• Verification of benefits (VOB)
• Prior authorizations (PA)
• Referrals
• Durable Medical Equipment (DME) and Urine Drug Screen billing
• Ensure accurate and timely claim submission to insurance carriers via Waystar Clearinghouse.
• Review claims for proper billing codes to minimize denials and rejections.
• Collect co-pays, co-insurance, deductibles, and outstanding balances from patients.
• Oversee statement generation and ensure timely patient communication regarding billing.
• Manage payment plans for patients with outstanding balances.

Compliance and Quality Assurance :

• Stay current with insurance policies, billing regulations, and coding standards.
• Conduct regular audits to ensure claims are properly coded and compliant with payer requirements.
• Monitor accounts receivable to ensure timely collections and address any billing disputes or delays.

Reporting and Metrics :

• Track, analyze, and report key performance indicators (KPIs) and billing metrics, including revenue cycle performance, denial rates, and collections.
• Provide regular updates to clinic leadership on billing performance and revenue trends.

Qualifications :

Education and Experience :

• Bachelor’s degree in healthcare administration, business, or a related field (preferred).
• Minimum of 3-5 years of experience in medical billing, with at least 2 years in a supervisory or management role.
• Experience in pain management billing is highly preferred.

Skills and Knowledge :

• Proficiency in eClinicalWorks EHR and Waystar Clearinghouse (or similar systems).
• In-depth knowledge of medical billing, coding (CPT, ICD-10), and insurance processes.
• Strong understanding of verification of benefits, prior authorizations, and durable medical equipment billing.
• Exceptional organizational and multitasking abilities with attention to detail.
• Effective leadership and team management skills.
• Strong communication skills to liaise with patients, staff, and insurance companies.

Working Conditions :

• Office-based with occasional need for remote coordination.
• Ability to work in a fast-paced environment with tight deadlines.

Supervisory Responsibility

Medical Billing Specialist

Work Environment

This job operates in a professional office environment.

Physical Requirements

Must be able to stand and sit for long periods of time. Carry up to 20 lbs at a time. Push patients in a wheelchair and on a gurney as needed.

Other Duties

This job description is not intended to be a comprehensive listing of all activities, duties, responsibilities, skills and / or working conditions that are associated with this job. Activities, duties, responsibilities, skills and / or working conditions may change at any time with or without notice.

Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Salary : $100,000 - $115,000