Job Description

Essential Responsibilities

• Manage daily physician billing operations, including charge processing, claim submission, payment posting, A/R follow-up, denials, and account resolution.
• Supervise, train, coach, and evaluate physician billing staff; monitor productivity, quality, and workload.
• Monitor key performance indicators, including days in A/R, aging, denial rates, clean claim rates, charge lag, collections, and staff productivity.
• Analyze denial and reimbursement trends and coordinate corrective actions with coding, registration, authorization, clinical departments, and payers.
• Research and resolve complex Medicare, Medicaid, Medicare Advantage, and commercial payer billing issues.
• Ensure billing activities comply with CMS, payer, HIPAA, and organizational requirements.
• Assist with development and maintenance of billing policies, procedures, workflows, claim edits, and departmental controls.
• Support revenue cycle system configuration, testing, upgrades, and implementation of new providers, clinics, and services.
• Collaborate with physicians, practice leadership, Finance, Coding, IT, Compliance, and other departments to improve revenue cycle performance.
• Assist the Director with reporting, budgeting, staffing, audits, strategic initiatives, and special projects.
• Serve as departmental leader and decision-maker in the Director’s absence.