Billing Manager - Full Time/Exempt - Coastal Healthcare

Billing Manager - Full Time/Exempt - Coastal Healthcare

Job Summary: The Billing Manager is responsible for overseeing all aspects of billing and revenue cycle operations, including claims processing, staff oversight, and compliance with payer requirements. This role ensures accurate and timely submission of claims, including review of claim errors, denial management, reconsiderations, adjustments, CIFs, refunds, and appeals.

In addition to Billing Manger responsibilities, the Billing Manager supports key operational and clerical functions such as review of patient demographics, processing payments and deposits, handling medical records requests, and responding to subpoenas. The position plays a critical role in managing inquiries related to claims and patient balances from patients, staff, and providers.

The Billing Manager also leads workflow optimization, reporting, and system support efforts, contributing to improved efficiency, compliance, and overall organizational performance.

This position will work very closely with Director and clinic supervisors/managers.

Education, Certifications/Licensure, and Experience:

Required:

• Billing/Coding certification

• 2+ years medical billing experience

• 2+ year in a Supervisory or lead role

Preferred:

• EHR experience (Athena preferred)

• Bilingual Spanish/English

Required Skills/Abilities:

• Knowledge of billing, coding, and payer regulations

• Strong leadership and organizational skills

• Analytical and problem-solving ability

• Proficiency in EHR and payer systems

Essential Duties and Responsibilities:

Revenue Cycle Oversight

• Manage claims processing: submission, denials, appeals, adjustments, and collections

• Ensure timely, accurate clean claims and resolve discrepancies

• Monitor A/R, patient balances, and denial trends

Billing Staff Supervision

• Oversee daily operations and staff assignments

• Train, support, and evaluate billing staff performance

• Maintain productivity and workflow standards

Coding, Compliance & Audits

• Oversee CPT, ICD-10, HCPCS updates and coding accuracy

• Quality/MIPs claims reporting

• Conduct chart reviews and staff training

• Support internal and external audits (HEDIS, HMS, etc.)

Payer & Credentialing

• Maintain payer policies, fee schedules

• Entity and Provider Data Management/Attestations (Payer Portal PDM and CAQH)

• Manage PAR/Non-PAR, MPN lists, and provider credentialing

• Track provider expirable (DEA, licenses, COI)

Systems & Reporting

• Manage Athena EMR workflows, templates, and user access

• Oversee EDI/EFT, payer portal administration and system interfaces (HIE, labs, CAIR)

• Generate and analyze reports; train staff on report usage

Operations Support

• Assist with workflows, training, and cross-department coordination

• Support budgeting, vendor management, and supply ordering

• Handle deposits, mail distribution, and administrative functions