Manager, Billing & Reimbursement

Independent Living Systems • Miami, FL

12d

About The Position

Independent Living Systems (ILS), together with affiliated health plans Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for vulnerable populations. The Manager, Billing & Reimbursement oversees billing operations and reimbursement processes, ensuring accurate and timely provider claim submissions, effective revenue cycle management, and compliance with regulatory requirements. The role collaborates with clinical, financial, and administrative teams to resolve billing discrepancies and improve reimbursement outcomes. It also leads a team that monitors payer contracts, analyzes reimbursement trends, and implements process improvements to strengthen financial performance and support patient service excellence.

Requirements

• Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field; relevant experience may substitute for the education requirement on a year-for-year basis.
• At least 5 years of experience in healthcare provider billing and reimbursement, including at least 2 years in a supervisory or management role.
• Strong knowledge of medical billing processes, CPT/HCPCS coding, and payer reimbursement methodologies.
• Familiarity with healthcare regulations, including HIPAA, Medicare, Medicaid, and commercial insurance requirements.
• Proficiency with electronic health record (EHR) systems and billing software.

Nice To Haves

• Master’s degree in Healthcare Administration, Business, or a related discipline.
• Certification such as Certified Professional Biller (CPB) or Certified Revenue Cycle Professional (CRCP).
• Experience working with multiple payer contracts and complex reimbursement models.
• Demonstrated success leading process improvement projects in a healthcare revenue cycle environment.
• Strong analytical skills and experience using data analytics tools to support decision-making.

Responsibilities

• Demonstrate commitment to the organization’s mission and model ILS Experience Standards of Excellence.
• Manage and supervise daily provider billing and reimbursement team operations to ensure accurate and timely claim submissions.
• Develop and implement strategies to optimize reimbursement rates and reduce denials by analyzing payer contracts and reimbursement trends.
• Collaborate with clinical and administrative departments to resolve billing issues, discrepancies, and compliance concerns.
• Monitor regulatory changes and ensure billing practices comply with federal, state, and payer-specific guidelines.
• Prepare and present regular reports on billing performance, reimbursement metrics, and process improvement initiatives to senior leadership.
• Train, mentor, and evaluate team members to maintain high standards of accuracy and productivity.
• Lead initiatives to streamline billing workflows and integrate new technologies or software to enhance operational efficiency.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager