Manager, Billing & Reimbursement

Independent Living Systems, LLC• Miami, FL, US, FL

About The Position

The Manager, Billing & Reimbursement is a leadership role at Independent Living Systems (ILS), affiliated with Florida Community Care and Florida Complete Care. The position oversees provider billing operations and reimbursement processes, ensuring provider claims are submitted accurately and on time, revenue cycle management is optimized, and regulatory requirements are met. The manager works with clinical, financial, and administrative teams to resolve billing discrepancies and improve reimbursement outcomes. They lead a team that monitors payer contracts, analyzes reimbursement trends, and implements process improvements to support financial performance and patient service excellence.

Requirements

  • Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field; relevant experience may substitute for education 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 and requirements, including HIPAA, Medicare, Medicaid, and commercial insurance.
  • 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 drive 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 follow 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 improve operational efficiency.
  • Perform other duties as assigned.
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