Healthcare Billing Manager — AI-Driven Revenue Cycle

USA Clinics Group; Northbrook (IL); On-site; USD 80,000 - 90,000; Full time

Benefits offered by this job

Health insurance

HSA

Dental

Vision

PTO

401k

Job summary

USA Clinics Group, located at the corporate office in Northbrook, IL, seeks a Billing Manager to lead the revenue cycle billing operations. This role focuses on timely claim submissions, workflow efficiency, and payer-compliant processes, reporting to the Revenue Cycle Management team.

The ideal candidate has 3+ years in healthcare billing, CPT/HCPCS/ICD-10 coding knowledge, and proficiency with practice management systems and Excel.

Qualifications

• Minimum three years of healthcare billing or revenue cycle experience.
• Strong knowledge of physician billing practices and claim submission workflows.
• Working knowledge of CPT, HCPCS, and ICD-10 coding as related to billing operations.
• Experience with insurance carriers, clearinghouses, and practice management systems.
• Proficiency in Microsoft Excel and Microsoft Office applications.
• Ability to manage multiple priorities in a fast-paced environment.

Responsibilities

• Oversee daily billing activities to ensure accurate and timely claim submission.
• Monitor billing workflows, work queues, and claim processing activities.
• Ensure claims are submitted in accordance with payer requirements and internal standards.
• Review clearinghouse reports and payer responses to identify and resolve submission issues.
• Coordinate claim corrections, rebills, and resubmissions as necessary.
• Maintain efficient billing workflows and operational procedures.
• Escalate system or workflow issues affecting claim submission and processing.
• Review billing-related coding edits affecting claim submission.
• Coordinate coding corrections required for claim processing.
• Ensure charges are billed accurately in accordance with established procedures.
• Support implementation of coding, billing, and payer-required updates.
• Assist with review of charge discrepancies and claim edits.
• Maintain working knowledge of CPT, HCPCS, and ICD-10 coding requirements related to billing operations.
• Ensure compliance with payer guidelines, billing regulations, and company policies.
• Maintain billing procedures, workflows, and standard operating procedures.
• Participate in system testing, billing updates, and workflow enhancements.
• Support internal audits and billing quality reviews.
• Maintain HIPAA compliance and safeguard patient and financial information.
• Assist with departmental projects and process improvement initiatives.
• Utilize AI-enabled tools to identify claim errors and prioritize billing activities.
• Monitor automated claim scrubbing and billing workflow processes.
• Support implementation of automation technologies that improve billing efficiency and accuracy.
• Participate in testing and deployment of revenue cycle technology enhancements.
• Promote utilization of technology solutions that streamline claim submission and error resolution.
• Support departmental goals and operational initiatives.

Skills

Healthcare billing

Analytical skills

Multi-tasking

Attention to detail

Education

Bachelor's or Associate's degree

CPB/CPC certification (preferred)

Tools

Practice management systems

Microsoft Excel

Clearinghouses

Job description

USA Clinics Group, located at the corporate office in Northbrook, IL, seeks a Billing Manager to lead the revenue cycle billing operations. This role focuses on timely claim submissions, workflow efficiency, and payer-compliant processes, reporting to the Revenue Cycle Management team.

The ideal candidate has 3+ years in healthcare billing, CPT/HCPCS/ICD-10 coding knowledge, and proficiency with practice management systems and Excel.