Medical Billing Manager

Tribal Diagnostics is searching for a Medical Billing Manager in Oklahoma City.  This is a full-time in-office position.  The salary range is $60,000 - $80,000 depending on experience level. The hours are Monday through Friday from 8am - 5pm. 

Job Summary:

The Medical Billing Manager at Tribal Diagnostics will oversee all aspects of the billing operations, ensuring accurate and timely invoicing for medical services provided to clients and insurance providers. This role will manage billing staff, oversee claims submission, payment reconciliation, denial management, and maintain compliance with healthcare billing standards. The Medical Billing Manager will also lead process improvements and automation efforts to enhance efficiency.

Duties/Responsibilities

• Manage, train, and mentor the billing team to ensure high performance and compliance with regulations.
• Conduct regular performance evaluations and provide feedback to staff.
• Delegate tasks effectively to ensure all billing operations are covered efficiently.
• Monitor team productivity, setting clear objectives and deadlines.
• Collaborate with HR on hiring and training new team members as needed.
• Oversee the preparation and submission of insurance claims for medical services, ensuring adherence to CPT, ICD-10, and HCPCS coding standards and billing regulations.
• Verify patient insurance eligibility and the accuracy of patient information for claims submission.
• Review, correct, and resubmit denied or rejected claims to secure prompt payment.
• Manage pricing updates with vendors, including setting CPT code rates and negotiating vendor pricing (e.g., CPL).
• Reconcile payments from insurance providers and identify discrepancies in billed claims.
• Investigate and resolve payment discrepancies, denials, and appeals promptly.
• Oversee the accurate posting of payments to patient accounts.
• Track and analyze denial trends, identifying areas for improvement and staff education.
• Generate and analyze billing reports to monitor collections, accounts receivable aging, and overall billing performance.
• Address billing inquiries from clients, patients, and insurance providers with professionalism.
• Coordinate with healthcare providers to resolve coding issues and educate them on billing processes and insurance requirements.
• Work with the sales team to maintain accurate client accounts and communicate billing rates to external partners.
• Ensure all billing activities comply with HIPAA, industry standards, and internal policies.
• Identify and implement process improvements and automation opportunities to enhance efficiency and accuracy.
• Maintain thorough documentation of billing processes and workflows.
• Stay updated on changes in healthcare billing regulations and communicate necessary changes to the team.

Education and Experience:

• Bachelor’s degree in finance, healthcare administration, or a related field (or equivalent experience).
• Previous experience in medical billing, claims processing, or revenue cycle management, with leadership experience preferred.
• In-depth knowledge of medical billing codes (CPT, ICD-10, HCPCS) and insurance billing procedures.

Required Skills/Abilities:

• Strong analytical and problem-solving skills.
• Proficiency in billing software and Microsoft Office Suite, particularly Excel.
• Exceptional communication and interpersonal skills for managing both staff and external partners.
• High attention to detail and ability to identify discrepancies.
• Capability to manage multiple priorities, deadlines, and stress effectively.

Physical Requirements:

• The ability to move within the office environment, including sitting, standing, and walking, as necessary to perform job duties and interact with colleagues.
• Extended periods of sitting at a desk or computer workstation while performing billing tasks, data analysis, and administrative work.
• Effective verbal and written communication skills for interacting with colleagues, clients, patients, and insurance providers, both in person and through electronic communication.
• The ability to manage job-related stress, meet deadlines, and work effectively under pressure during peak billing periods.
• Accurate and efficient typing skills for data entry, claims processing, and documentation.
• High attention to detail to ensure billing accuracy and to identify discrepancies in claims and payments.