Billing Manager, Medical Care at Home
VNS Health, New York, NY, United States
Overview
Leads and oversees the billing and revenue cycle operations for Medical Care at Home, including accurate and timely claim submission, denial tracking, resubmission and appeals management. This role is responsible for ensuring accurate reimbursement, optimizing revenue cycle performance, and maintaining compliance with regulatory and payer requirements. Partners with clinical, operational, and leadership teams to improve documentation, coding accuracy, and billing workflows, while driving continuous process improvement and operational efficiency.
What We Provide
Referral bonus opportunities
Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
Employer‑matched retirement saving funds
Personal and financial wellness programs
Pre‑tax flexible spending accounts (FSAs) for healthcare and dependent care
Generous tuition reimbursement for qualifying degrees
Opportunities for professional growth and career advancement
What You Will Do
Oversees all aspects of medical practice billing and revenue cycle operations, including charge capture, coding review, claim submission, denial management, and accounts receivable follow‑up.
Manages a team responsible for day to day billing operations, ensuring productivity, accuracy, and adherence to established policies, procedures, and timelines.
Monitors and drives key revenue cycle performance metrics (e.g., clean claim rate, denial rate, days in A/R, net collection rate), implementing strategies to improve financial outcomes and reduce revenue leakage.
Develops and implements processes to prevent, identify, and resolve claim denials, underpayments, and reimbursement issues in a timely and effective manner.
Provides hands‑on support for complex or escalated billing issues, including review and resolution of high‑priority claims and appeals.
Oversees performance and accountability of external billing vendors and clearinghouses, including management of service level agreements, quality metrics, and issue resolution.
Ensures compliance with federal, state, and payer‑specific billing regulations, including proper use of CPT, ICD‑10, and HCPCS coding standards.
Collaborates with clinical and administrative teams to ensure accurate charge capture, documentation, and coding practices that support optimal reimbursement.
Identifies trends and root causes of billing and reimbursement issues; develops and implements corrective action plans and process improvements.
Establishes and maintains tracking and reporting to monitor billing performance, track key metrics, and inform leadership decision‑making.
Supports implementation and optimization of billing systems, workflows, and technologies to improve efficiency and accuracy.
Performs all duties inherent in a managerial role, including hiring, coaching, performance management, and staff development. Participates in budget planning and ensures adherence to departmental financial goals.
Participates in special projects and performs other duties as assigned.
Qualifications
Education
Bachelor's Degree in healthcare administration, business, or related field; or the equivalent work experience required.
Work Experience
Minimum of 5-7 years of experience in healthcare billing, claims processing, or revenue cycle management required.
Experience with physician/practice billing, ambulatory care, or home‑based care billing preferred.
Proven leadership and team management skills required.
Minimum of 2–3 years of leadership or supervisory experience managing billing or revenue cycle teams preferred.
Demonstrated experience managing billing vendors or outsourced revenue cycle functions preferred.
Proficient PC skills, and particularly proficiency in Microsoft Excel and reporting tools required.
Experience working with electronic health records (EHR), practice management systems, and billing/claims platforms required.
Strong knowledge of end‑to‑end revenue cycle processes, including charge capture, coding, claims submission, denial management, and accounts receivable follow‑up required.
Experience in problem‑solving and analytical skills required.
Working knowledge of CPT, ICD‑10, and HCPCS coding required.
Knowledge of healthcare regulations, payer requirements, and compliance standards related to billing and reimbursement required.
Effective communication skills, both written and oral required.
Pay Range
USD $93,400.00 - USD $116,800.00 /Yr.
#J-18808-Ljbffr
Leads and oversees the billing and revenue cycle operations for Medical Care at Home, including accurate and timely claim submission, denial tracking, resubmission and appeals management. This role is responsible for ensuring accurate reimbursement, optimizing revenue cycle performance, and maintaining compliance with regulatory and payer requirements. Partners with clinical, operational, and leadership teams to improve documentation, coding accuracy, and billing workflows, while driving continuous process improvement and operational efficiency.
What We Provide
Referral bonus opportunities
Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
Employer‑matched retirement saving funds
Personal and financial wellness programs
Pre‑tax flexible spending accounts (FSAs) for healthcare and dependent care
Generous tuition reimbursement for qualifying degrees
Opportunities for professional growth and career advancement
What You Will Do
Oversees all aspects of medical practice billing and revenue cycle operations, including charge capture, coding review, claim submission, denial management, and accounts receivable follow‑up.
Manages a team responsible for day to day billing operations, ensuring productivity, accuracy, and adherence to established policies, procedures, and timelines.
Monitors and drives key revenue cycle performance metrics (e.g., clean claim rate, denial rate, days in A/R, net collection rate), implementing strategies to improve financial outcomes and reduce revenue leakage.
Develops and implements processes to prevent, identify, and resolve claim denials, underpayments, and reimbursement issues in a timely and effective manner.
Provides hands‑on support for complex or escalated billing issues, including review and resolution of high‑priority claims and appeals.
Oversees performance and accountability of external billing vendors and clearinghouses, including management of service level agreements, quality metrics, and issue resolution.
Ensures compliance with federal, state, and payer‑specific billing regulations, including proper use of CPT, ICD‑10, and HCPCS coding standards.
Collaborates with clinical and administrative teams to ensure accurate charge capture, documentation, and coding practices that support optimal reimbursement.
Identifies trends and root causes of billing and reimbursement issues; develops and implements corrective action plans and process improvements.
Establishes and maintains tracking and reporting to monitor billing performance, track key metrics, and inform leadership decision‑making.
Supports implementation and optimization of billing systems, workflows, and technologies to improve efficiency and accuracy.
Performs all duties inherent in a managerial role, including hiring, coaching, performance management, and staff development. Participates in budget planning and ensures adherence to departmental financial goals.
Participates in special projects and performs other duties as assigned.
Qualifications
Education
Bachelor's Degree in healthcare administration, business, or related field; or the equivalent work experience required.
Work Experience
Minimum of 5-7 years of experience in healthcare billing, claims processing, or revenue cycle management required.
Experience with physician/practice billing, ambulatory care, or home‑based care billing preferred.
Proven leadership and team management skills required.
Minimum of 2–3 years of leadership or supervisory experience managing billing or revenue cycle teams preferred.
Demonstrated experience managing billing vendors or outsourced revenue cycle functions preferred.
Proficient PC skills, and particularly proficiency in Microsoft Excel and reporting tools required.
Experience working with electronic health records (EHR), practice management systems, and billing/claims platforms required.
Strong knowledge of end‑to‑end revenue cycle processes, including charge capture, coding, claims submission, denial management, and accounts receivable follow‑up required.
Experience in problem‑solving and analytical skills required.
Working knowledge of CPT, ICD‑10, and HCPCS coding required.
Knowledge of healthcare regulations, payer requirements, and compliance standards related to billing and reimbursement required.
Effective communication skills, both written and oral required.
Pay Range
USD $93,400.00 - USD $116,800.00 /Yr.
#J-18808-Ljbffr