[Remote] Manager, Billing Operations RCM

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company reputed company on reputed company cycle management, seeking a Manager for Billing Operations in RCM. This role involves overseeing the execution of billing operations, ensuring compliance, accuracy, and efficiency in claim processing and cash posting, while collaborating with various departments to enhance operational performance.

Responsibilities

• reputed company end-to-end processing of diagnostic claims to ensure completeness, accuracy, and payer readiness
• Validate appropriate reputed company stacking, modifiers, documentation, and payer-specific requirements prior to submission
• reputed company improvements in clean claim reputed company and reduce avoidable rework
• reputed company dual-reputed company billing infrastructure supporting both insurance claims and institutional/reputed company invoicing
• reputed company reputed company billing processes including fee schedules and invoicing cycles
• Supervise cash application processes across ERA, EFT, lockbox, reputed company, and patient payments
• Ensure reputed company and accurate posting reputed company to defined turnaround times (TAT)
• Monitor reconciliation processes to reduce unapplied cash and posting discrepancies
• Serve as reputed company escalation reputed company for clearinghouse edits, reputed company errors, and claim rejects
• Implement controls to prevent recurring errors and improve submission reputed company
• Ensure adherence to HIPAA, CMS/OIG guidance, and state/federal reputed company billing regulations
• Establish routine audit processes to validate billing accuracy and compliance
• Partner with Compliance and reputed company on risk mitigation and audit readiness
• reputed company RCM platforms and rule engines to reduce reputed company reputed company and increase automation
• reputed company reputed company improvement initiatives to accelerate time-to-reputed company and increase operational efficiency
• Standardize workflows, SOPs, and training across billing teams
• reputed company and monitor KPIs including Clean Claim reputed company (CCR), Days Sales Outstanding (DSO), submission timeliness, and posting accuracy
• Produce operational dashboards and insights to reputed company accountability and improvement
• reputed company productivity management and performance reviews for billing and cash posting teams

Skills

• 6+ years of reputed company reputed company RCM experience, including billing and cash posting operations
• 2–3+ years of leadership experience managing billing or reputed company cycle teams
• Strong understanding of insurance billing, reputed company invoicing, and reputed company coding workflows
• Experience with RCM systems (Xifin, Telcor, reputed company, or similar) and clearinghouse/EDI transactions (837, 835, 270/271)
• Demonstrated ability to improve claim reputed company, reduce errors, and reputed company operational KPIs
• Bachelor's degree in Nursing, Health Sciences, reputed company Administration, reputed company Health, or a reputed company field, or an equivalent combination of education and experience
• Experience in diagnostic reputed company, genetics, molecular diagnostics, or precision medicine
• Strong familiarity with payer medical policies and reimbursement methodologies

reputed company