Medical Billing Manager
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Job Description
Medical Billing Manager overseeing coding and billing operations for ReKlame Health, a clinician-led provider group. Ensuring accuracy, compliance, and adaptability within the complexities of the American healthcare system.
Responsibilities:
- Lead and oversee all aspects of the billing process, including claims submission, payment processing, and account reconciliation, ensuring accuracy and efficiency.
- Ensure accurate, compliant coding with ICD-10, CPT, and HCPCS systems to optimize first-pass claim submissions and maximize revenue for patient care and procedures.
- Establish scalable workflows to address multi-state billing complexities, with a focus on state-specific Medicaid requirements and streamlined reimbursements.
- Monitor and implement changes in Medicare, Medicaid, and other regulatory guidelines, ensuring full compliance across all billing and coding processes.
- Conduct regular audits to uphold coding standards, identify gaps, and ensure accurate documentation and billing practices.
- Partner with providers, administrative teams, and payers to address documentation gaps, efficiently resolve coding challenges, and reduce claim denials.
- Identify skill gaps and develop tailored training initiatives, such as workshops, coaching sessions, and resource playbooks, to enhance team capabilities.
- Serve as the expert in coding and billing complexities, particularly in navigating multi-state Medicaid and Medicare nuances.
- Leverage emerging technologies and automation tools to optimize billing operations, enhance team performance, and support long-term cost efficiency.
Requirements:
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification in medical coding is mandatory.
- Minimum of 3-5 years of professional experience in medical coding and billing, including expertise with Medicare and Medicaid systems.
- Strong preference for candidates with experience in behavioral health coding.
- Demonstrated experience leading and mentoring a team, with a history of improving performance and operational workflows.
- Advanced proficiency with ICD-10, CPT, and HCPCS coding systems and experience with EHR and medical billing software.
- Exceptional accuracy and attention to detail in coding/billing and documentation.
- Strong understanding of HIPAA and healthcare compliance guidelines, with the ability to adapt to changing regulations.
- Exceptional written and verbal communication abilities to effectively collaborate with stakeholders at all levels.
- Analytical mindset with the ability to address complex challenges, identify solutions, and implement improvements with speed and accuracy.
Benefits:
- Health insurance
- Paid time off
- Remote work options
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