Billing Manager, Multi-state Healthcare System

USA Clinics Group•Northbrook, IL

7d•Onsite

About The Position

The Billing Manager is responsible for overseeing billing operations to ensure accurate and timely claim submission, claim correction, billing workflow management, and resolution of claim-related issues. This position supports the Revenue Cycle Management team by maintaining efficient billing processes, ensuring compliance with payer requirements, monitoring claim activity, and supporting operational initiatives that improve claim accuracy and billing efficiency.

Requirements

Associate's or Bachelor's degree preferred, or equivalent combination of education and experience.
Minimum three (3) years of healthcare billing or revenue cycle experience.
Strong knowledge of physician billing practices and claim submission workflows.
Working knowledge of CPT, HCPCS, and ICD-10 coding as related to billing operations.
Experience with insurance carriers, clearinghouses, and practice management systems.
Strong analytical, organizational, and problem-solving skills.
Proficiency in Microsoft Excel and Microsoft Office applications.
Ability to manage multiple priorities in a fast-paced environment.

Nice To Haves

Certified Professional Biller (CPB), CPC, or other related certification.
Experience in a multi-site physician practice environment.
Experience utilizing revenue cycle automation and AI-enabled workflow tools.

Responsibilities

Oversee daily billing activities to ensure accurate and timely claim submission.
Monitor billing workflows, work queues, and claim processing activities.
Ensure claims are submitted in accordance with payer requirements and internal standards.
Review clearinghouse reports and payer responses to identify and resolve submission issues.
Coordinate claim corrections, rebills, and resubmissions as necessary.
Maintain efficient billing workflows and operational procedures.
Escalate system or workflow issues affecting claim submission and processing.
Review and resolve claim edits, rejections, and billing exceptions.
Investigate claim submission issues and coordinate corrective actions.
Monitor rejected claims to ensure timely correction and resubmission.
Track unresolved billing issues through completion.
Ensure billing-related errors are resolved accurately and promptly.
Support initiatives designed to improve claim accuracy and reduce submission errors.
Review billing-related coding edits affecting claim submission.
Coordinate coding corrections required for claim processing.
Ensure charges are billed accurately in accordance with established procedures.
Support implementation of coding, billing, and payer-required updates.
Assist with review of charge discrepancies and claim edits.
Maintain working knowledge of CPT, HCPCS, and ICD-10 coding requirements related to billing operations.
Ensure compliance with payer guidelines, billing regulations, and company policies.
Maintain billing procedures, workflows, and standard operating procedures.
Participate in system testing, billing updates, and workflow enhancements.
Support internal audits and billing quality reviews.
Maintain HIPAA compliance and safeguard patient and financial information.
Assist with departmental projects and process improvement initiatives.
Utilize AI-enabled tools to identify claim errors and prioritize billing activities.
Monitor automated claim scrubbing and billing workflow processes.
Support implementation of automation technologies that improve billing efficiency and accuracy.
Participate in testing and deployment of revenue cycle technology enhancements.
Promote utilization of technology solutions that streamline claim submission and error resolution.
Support departmental goals and operational initiatives.
Participate in meetings, audits, projects, and process improvement activities.
Provide cross-functional support within the Revenue Cycle Management department.
Perform other duties as assigned.