CAH-Billing Manager

Claxton-Hepburn Medical Center; Village of Carthage (NY); On-site; USD 76,000 - 101,000; Full time

Job summary

Claxton-Hepburn Medical Center in Carthage, NY is seeking a CAH-Billing Manager to lead the hospital's insurance accounts receivable operations. The role focuses on timely reimbursement, denial prevention, and proactive follow-up with commercial, Medicare, Medicaid, and managed care payers.

Responsibilities include monitoring payer trends, ensuring regulatory compliance, and implementing process improvements to reduce denials and AR days.

Qualifications

• Minimum of five (5) years of progressive hospital insurance billing, accounts receivable, or revenue cycle experience.
• Demonstrated experience in insurance follow-up, denial management, and payer reimbursement.
• Working knowledge of Medicare, Medicaid, commercial insurance, and managed care billing requirements.

Responsibilities

• Provide leadership and oversight of insurance accounts receivable operations.
• Manage and monitor insurance A/R work queues to ensure timely claim resolution and reimbursement.
• Lead denial management efforts, including root cause analysis and corrective action planning.
• Collaborate with payer representatives to resolve complex claim and payment issues.
• Escalate unresolved payer issues through provider and payer channels when necessary.

Skills

Billing management

Staff supervision

Process improvement

Regulatory compliance

Education

High School Diploma or equivalent

Bachelor's degree in Business, Healthcare Administration, Finance, or related field

Tools

Revenue Cycle System

EDI processes

Revenue cycle analytics

Hospital billing systems

Job description

CAH-Billing Manager

Claxton-Hepburn Medical Center Carthage, New York, United States

About this position

CAH-Billing Manager – Full Time Day Shift
Pay Range: $36.54–$48.41*

The Billing Manager provides leadership and oversight of the hospital's insurance accounts receivable operations, with a primary focus on timely reimbursement, denial prevention and resolution, payer follow-up, and accounts receivable performance. This position is responsible for managing complex insurance claims, coordinating with commercial, Medicare, Medicaid, and managed care payers, and ensuring accurate reimbursement through proactive follow-up and escalation.

The position monitors payer trends, denial patterns, regulatory changes, and reimbursement policies to ensure compliance while implementing process improvements that reduce denials, improve collections, and decrease accounts receivable days outstanding. Through effective use of the Revenue Cycle System, the Billing Manager evaluates workflow efficiencies, develops staff, and ensures operational excellence while achieving industry benchmark performance metrics.

Essential Responsibilities

• Provide leadership and oversight of insurance accounts receivable operations.
• Manage and monitor insurance A/R work queues to ensure timely claim resolution and reimbursement.
• Lead denial management efforts, including identifying trends, root cause analysis, appeals, and corrective action planning.
• Work directly with commercial, Medicare, Medicaid, and managed care payer representatives to resolve complex claim and payment issues.
• Escalate unresolved payer issues through provider representatives and payer liaison channels when necessary.
• Monitor payer reimbursement accuracy and identify underpayments or contract compliance concerns.
• Ensure timely billing, follow-up, and payment of hospital claims while maintaining compliance with federal, state, and payer regulations.
• Monitor key revenue cycle performance indicators including A/R Days, Aging, Denial Rate, Clean Claim Rate, First Pass Resolution, and Cash Collections.
• Analyze payer trends and develop strategies to reduce denials and improve reimbursement performance.
• Identify workflow improvements and automation opportunities within the Revenue Cycle System to increase operational efficiency.
• Develop departmental policies and procedures that support best practices in insurance billing and collections.
• Supervise, mentor, and develop billing staff while establishing productivity and quality expectations.
• Prepare and present revenue cycle performance reports to executive leadership.
• Maintain knowledge of payer policies, reimbursement methodologies, regulatory requirements, and industry best practices.

Reports To: Director of Revenue Cycle

Education

Required

• High School Diploma or equivalent

Preferred

• Bachelor's degree in Business, Healthcare Administration, Finance, or related field.

Training & Experience

Required

• Minimum of five (5) years of progressive hospital insurance billing, accounts receivable, or revenue cycle experience.
• Demonstrated experience in insurance follow-up, denial management, and payer reimbursement.
• Working knowledge of Medicare, Medicaid, commercial insurance, and managed care billing requirements.

Preferred

• Three (3) years of supervisory or management experience in a healthcare revenue cycle environment.
• Experience with hospital billing systems, EDI processes, and revenue cycle analytics.
• Knowledge of revenue cycle KPIs, payer contract reimbursement methodologies, and regulatory compliance.

Salary Information

$36.54 - $48.41Hourly Wage

*The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts. Carthage Area Hospital and Claxton Hepburn Medical Center are Equal Opportunity/Affirmative Action Employers. Minority/Female/Disability/Veterans are encouraged to apply.*