Job Description

Job Description

Job Description

Description:

Oversee the billing operations for a multi-location pediatric and counseling outpatient practice, ensuring accurate, efficient, and compliant revenue cycle processes. This individual will lead a team of billing professionals, monitor key performance indicators (KPI's), and implement best practices to optimize cash flow, enhance patient satisfaction, and maintain compliance with healthcare regulations.

Duties and Responsibilities

Leadership and Management

• Oversee all billing operations across assigned locations to ensure consistent, high-quality performance.
• Recruit, train, and mentor billing staff, fostering a culture of accountability and professional growth.
• Collaborate with senior leadership and site leaders to align billing practices with organizational goals.
• Revenue Cycle Management
• Assist in developing and executing strategies to streamline billing and collections processes, including charge capture, claims submission, and denial management.
• Monitor and analyze key metrics such as days in accounts receivable (A/R), collection rates, and denial trends.
• Identify and address revenue leakage and implement corrective actions.

Compliance and Quality Assurance

• Ensure billing processes comply with federal, state, and local healthcare regulations, including HIPAA and payer-specific requirements.
• Conduct regular audits of billing and coding practices to minimize compliance risks and maintain data accuracy.
• Stay updated on changes in healthcare billing regulations and payer policies, ensuring timely implementation of adjustments.

Technology and Systems

• Manage and optimize billing software systems to improve efficiency and reporting capabilities.
• Serve as the point of contact for IT and third-party vendors related to billing systems and processes.
• Drive the implementation of new tools and technologies that enhance operational efficiency.

Reporting and Communication

• Prepare and present financial and operational reports to senior leadership, highlighting trends, challenges, and opportunities.
• Act as a liaison between billing teams and clinical/administrative staff to resolve billing-related issues and improve workflows.
• Maintain open communication with patients and senior leadership regarding billing policies and concerns.

Qualifications

• High School diploma required and college degree preferred.
• Minimum of 3–5 years of experience in revenue cycler management with at least 1 year in a managerial or supervisory role.
• Experience in a multi-location or regional healthcare setting is highly desirable.

Skills and Abilities

• Strong knowledge of medical billing and coding, including CPT, ICD-10, and HCPCS.
• Familiarity with payer rules, insurance contracts, and reimbursement methodologies.
• Proficiency in billing software and revenue cycle management tools with eClinicalworks as preferred history.
• Exceptional analytical, organizational, and problem-solving skills.
• Effective communication and interpersonal skills, with the ability to lead diverse teams.
• Ability to manage competing priorities and meet deadlines in a fast-paced environment.
• Ability to communicate effectively both orally and in writing.
• Working knowledge of relevant policies and regulations.
• Ability to flexibly respond to changing demands.
• Strong attention to detail and analytical skills.
• Ability to work both independently and collaboratively in a team environment.

Certifications

• Certified Professional Biller (CPB), Certified Professional Coder (CPC), or equivalent certification preferred.

Working Environment

• Office-based.
• Collaborative, patient-focused environment.
• Some travel required.

Physical Demands

• Ability to sit for extended periods while working on a computer or attending meetings.

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