Remote Senior Manager, Clinical Audit & Billing Oversight

Socket.dev; Fort Worth (TX); On-site; USD 93,000 - 144,000; Full time

Job summary

CERIS, a division of CorVel, is seeking a Senior Manager, Clinical Audit to lead multiple audit and billing teams in a fast-paced environment. You will oversee reviews of medical bills and coding, ensuring accurate results while maintaining HIPAA confidentiality.

The role involves onsite visits and travel as needed, with a remote work setup. Strong leadership, healthcare billing expertise, and proficiency in Excel are essential to success in this role.

Qualifications

• RN licensure required; keep current in state of employment.
• Bachelor’s or Master’s in nursing or related field preferred.
• 5+ years in healthcare billing audit or related field.
• 3+ years leadership experience required.
• Additional nursing, coding, business management, or medical bill review certifications are a plus.

Responsibilities

• Lead teams of auditors and billing staff to plan, execute, and deliver results.
• Maintain client communications with professionalism and timeliness.
• Build and manage remote and onsite teams through hiring and development.
• Implement performance metrics and evaluation systems for team performance.
• Oversee HR duties for direct and indirect staff.
• Track KPIs and SLAs, drive process improvements.
• Report departmental metrics to leadership as requested.
• Ensure turnaround times and SLAs comply with client requirements.
• Oversee daily, weekly, and monthly reports, invoices, and expenses.
• Serve as point of contact for internal and external customers.
• Maintain HIPAA/patient confidentiality.

Skills

Critical thinking

Communication skills

Leadership

Microsoft Excel

HIPAA knowledge

Education

RN licensure

Bachelor’s or Master’s in nursing or related healthcare field

5+ years in healthcare billing audit

3+ years leadership experience

Additional nursing/coding/management certifications a plus

Tools

MS Office (Excel)

Job description

CERIS, a division of CorVel, is seeking a Senior Manager, Clinical Audit to lead multiple audit and billing teams in a fast-paced environment. You will oversee reviews of medical bills and coding, ensuring accurate results while maintaining HIPAA confidentiality.

The role involves onsite visits and travel as needed, with a remote work setup. Strong leadership, healthcare billing expertise, and proficiency in Excel are essential to success in this role.