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  Oversee and manage the daily operations of the medical billing department, ensuring the accurate and timely submission of claims to insurance providers, including Medicare, Medicaid, and direct patient billing.
• Ensure proper coding practices and compliance with payer requirements to optimize reimbursement and minimize claim rejections.
• Assign, monitor, and prioritize claims processing, proactively resolving issues that may delay payments.
• Conduct regular audits of billing processes to ensure alignment with industry regulations, including ICD and CPT coding standards.

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  Develop and implement strategies to minimize outstanding receivables, ensuring consistent cash flow.
• Monitor aging reports, following up on unpaid or denied claims, and coordinate with payers or patients to resolve payment issues.
• Negotiate payment plans with patients, handle escalated billing inquiries, and manage disputes with professionalism.
• Oversee external collection agency relationships and ensure appropriate escalation procedures are in place for unresolved accounts.
  

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  Lead, mentor, and provide hands-on training to the billing and collections team, ensuring adherence to company policies and achievement of departmental performance goals.
• Conduct regular team meetings to review key performance metrics, share updates on policy or procedural changes, and foster continuous process improvement.
• Assess staffing needs, participate in recruitment, and manage team schedules to maintain optimal departmental productivity.
• Offer constructive feedback and actively coach team members to create a collaborative and high-performing environment.

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  Generate, analyze, and present detailed reports on billing and collections performance, identifying trends, opportunities, and areas for improvement.
• Report key performance indicators (KPIs) to senior management, including collection rates, denial rates, and days in accounts receivable (AR).
• Leverage data analysis to implement corrective actions and optimize revenue cycle performance, ensuring timely and accurate financial reporting.
• Excel in data manipulation and provide clear, actionable insights through reporting tools.

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  Ensure all billing and collections activities adhere to federal, state, and local regulations, including HIPAA, Medicare, Medicaid, and other payer-specific requirements.
• Stay informed of changes in billing codes, payer policies, and healthcare regulations, ensuring the team is regularly updated and compliant.
• Proactively monitor regulatory updates and adjust internal processes as needed to remain in compliance with industry standards.

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  Partner with IT and cross-functional teams to optimize the use of billing software, enhancing system capabilities to improve efficiency and accuracy.
• Identify and implement process improvements within the billing and collections workflow, focusing on automating tasks where feasible.
• Oversee system updates and ensure all staff receive necessary training on new software features and process changes.
  

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  Lead the development and execution of strategic plans for the billing and collections department, aligning initiatives with the broader organizational objectives.
• Collaborate with senior leadership to set financial goals, budgets, and forecasts for the department, contributing to the overall financial strategy of the organization.
• Provide leadership and vision to drive performance, ensuring the team meets departmental and organizational targets.

• Maintain up-to-date knowledge of healthcare billing and collections regulations, ensuring compliance with HIPAA, Medicare, Medicaid, and other payer requirements.
• Implement risk mitigation strategies within billing and collections processes to minimize legal and financial exposure.
• Ensure the team adheres to industry best practices and maintains compliance with changing regulatory landscapes.

Qualifications:

• 7+ years of experience in medical billing and collections, with at least 3 years in a leadership or managerial role.
• Strong experience in healthcare billing, coding (ICD, CPT, HCPCS), claims processing, and payer regulations, including Medicare and Medicaid.
• Proven track record of managing teams and improving billing and collection operations in a healthcare setting.
• Demonstrated ability to reduce AR days, improve cash flow, and optimize revenue cycle processes.

Skills and Competencies:

• In-depth knowledge of healthcare billing systems and revenue cycle management.
• Strong leadership and team management skills, with the ability to motivate and develop high-performing teams.
• Proficiency in data analysis and reporting, with advanced skills in
• Excel Excellent communication, problem-solving, and negotiation skills to manage payer relations, patient inquiries, and disputes.
• Strong understanding of healthcare regulations and compliance, including HIPAA, Medicare, Medicaid, and other payer-specific requirements.
• Ability to work cross-functionally with IT, finance, and clinical teams to drive process improvements and technology initiatives.

Benefits

• Work from home

Schedule

• Schedule: Monday to Friday, with weekend availability as needed
• Expected Hours: 40 hours per week
• Time Zone Preference: Ability to work in U.S. time zones, preferably Pacific Standard Time (PST)