Primary Objective

The Medical Billing Manager is responsible for the financial operations of ensuring accurate and timely billing processes, managing claims, and maximizing revenue through effective billing and collection strategies.

Essential Functions & Scope

·       Oversee all aspects of RCM services for the entire state-wide organization including claims submission, payment posting, and accounts receivable management

·       Ensure timely and accurate billing processes

·       Ensure that all billing complies with regulations

·       Oversee the investigation and resolution of billing discrepancies, denials, and rejections, and work with insurance carriers and conservators to ensure proper reimbursement

·       Serve as the primary point of contact resolving any billing-related issues

·       Ensure the proper processing, tracking, and resolution of claims

·       Prepare and present regular billing reports, financial analysis, and metrics to management

·       Collaborate with CFO to dramatically improve the billing process

·       Maintain relationships with TennCare, MCOs, and Operations teams

·       Lead, train, and manage a medical billing specialist

·       Performs all other duties as directed by the CFO

Knowledge, Skills and Abilities

·       Bachelor's Degree in Health Care Administration or related field required

·       5-7+ years of strong medical billing experience

·       2-3 years of management experience with excellent leadership skills

·       Background in TennCare/MCO billing and collection operations

·       Strong experience with EMR/EHR systems

·       Proficiency in Microsoft Office Suite, especially Excel

Competencies

·       Positive, team player attitude

·       Excellent leadership and team management skills

·       Strong organizational and multi-tasking skills

·       Exceptional communication and negotiation skills

·       Ability to meet deadlines

·       High level of accuracy and attention to detail