• Oversee billing and coding operations and provide backup support to ensure the timely and accurate completion of responsibilities handled by direct reports.
• Conduct eligibility verification for all payers (Commercial, Managed Care, and HMO).
• Secure necessary PCP referral authorizations for office visits.
• Ensure compliance with federal, state, and payer-specific regulations relevant to the organization's specialties.
• Continuously monitor and refine procedures and workflows to identify the root causes of deficiencies.
• Implement workflow improvements, automate systems, and take corrective actions or seek additional training to ensure billing accuracy and prevent future errors.
• Collaborate with team members to identify trends in payer denials or billing practices that affect patient balances.
• Facilitate meetings to efficiently address, communicate, and resolve departmental issues.
• Partner with leadership to develop and implement strategic initiatives for the department.
• Oversee patient assistance programs to ensure timely access to medical care for patients, families, and caregivers.
• Evaluate and address training progress and performance expectations for new hires, as well as assess ongoing competencies for direct reports.
• Develop and maintain comprehensive documentation of procedures for assigned billing department tasks and responsibilities to ensure consistency and compliance.
• Support, contribute to, and execute the leadership's vision for the team.
• Cultivate an environment of cultural diversity and sensitivity and engage in training that highlights the importance of cultural awareness in delivering high-quality healthcare.
• Directly oversee employees within the billing department, ensuring that all supervisory duties are performed according to the organization’s policies and relevant regulations.
• Conduct interviews, hire and train staff, evaluate performance, administer rewards and disciplinary actions, and resolve issues.

Qualifications:

• A genuine passion and a deep appreciation for the mission of the organization.
• Four years of management experience and five years of expertise in healthcare revenue cycle management.
• Preferred qualifications include certification as a Certified Professional Coder (CPC), Certified Professional Biller (CPB), or Certified Physician Practice Manager (CPPM).
• Must have extensive knowledge in CPT and ICD-10 coding, and medical terminology.
• Proficiency in medical billing and coding across one or more of the following specialties is highly beneficial: oncology, hematology, orthopedics, rheumatology, infusions, hospital charges, orthotics, orthopedic surgery services, radiology, physical therapy, and behavioral health services.
• Prior experience in a physician's office is required; experience in a multi-specialty physician environment is preferred.
• Expertise in commercial insurance, managed care, HMO, and other insurance plan benefits and coverage.
• Ability to strategically integrate the diverse demands of a multi-specialty environment to foster a productive working atmosphere.
• Exceptional communication skills with a proven ability to build rapport and maintain confidentiality with patients and team members.
• Proficiency in Microsoft Teams, Word, and Excel.
• Bachelor's degree in Healthcare or an Associate's degree with five years of experience in healthcare or revenue cycle management is required; Master’s degree in Healthcare is preferred.