Billing/Coding Manager

Position Summary:

The Billing/Coding Manager oversees billing and coding operations for a multispecialty outpatient facility, including Behavioral Health, Chiropractic, Physical Therapy, Family Medicine, Nutrition, and Massage Therapy. This role ensures regulatory compliance, accurate coding, timely claim submission, and effective denial management. The ideal candidate demonstrates strong multi-payer billing knowledge, team leadership, and the ability to collaborate with Multispecialty Clinic Coordinators and clinical providers to support documentation accuracy and revenue cycle performance.

Key Responsibilities:

Leadership & Oversight:

• Supervise billing and coding staff with a focus on accuracy, compliance, and professional development. - Provide training and onboarding for new billing, insurance, and medical receptionist team members to ensure they are equipped with the knowledge and tools to succeed. - Develop and maintain insurance-compliant billing and coding protocols for all payers. - Serve as the subject matter expert on payer rules and requirements across all clinic specialties. - Serve as a liaison to external billing consultants or vendors when necessary to ensure efficient billing operations and issue resolution.

Insurance Billing & Coding (Multispecialty Focus):

• Ensure proper CPT, ICD-10, and HCPCS coding for all clinical services across Behavioral Health, Chiropractic, Physical Therapy, Family Medicine, Nutrition, and Massage Therapy. - Manage multi-payer claim submission, payment reconciliation, denial management, and appeals. - Stay current on payer-specific guidelines and communicate updates to billing and clinical staff.

Compliance & Quality Control:

• Ensure all billing and coding practices comply with payer policies, commercial guidelines, and HIPAA. - Lead internal audits and implement corrective actions as needed. - Support internal and external audits and maintain audit-readiness documentation.

Cross-Functional Collaboration:

• Work closely with Multispecialty Clinic Coordinators to ensure provider documentation supports proper coding and reimbursement. - Collaborate with providers and clinical teams to address documentation deficiencies and support compliance training. - Participate in multidisciplinary meetings to address workflow or documentation challenges affecting claims.

Revenue Integrity & Reporting:

• Monitor and report on KPIs such as clean claim rate, A/R aging, denial trends, and payer performance. - Proactively recommend and implement process improvements for efficiency and revenue capture. - Maintain current and accessible documentation of workflows, coding policies, and payer requirements.

Required:

• 3–5 years of billing and coding experience in a multispecialty or outpatient clinical setting. - 3+ years of experience managing medical billing and insurance teams (multi-location preferred). - Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent credential. - Proficiency with Athena and Jane EHR systems.

Preferred:

• Experience working with integrated care or outpatient multispecialty clinics. - Familiarity with commercial payer rules and prior authorization workflows. - Understanding of payer-specific requirements for Chiropractic and Physical Therapy billing. - Extensive knowledge of revenue cycle management, insurance verification, coding, denial management, and collections. - Proven ability to interpret and act on financial reports, insurance aging, and performance KPIs.
• Familiarity with Medicare and major commercial insurance payers; knowledge of cash-based and insurance-based hybrid service models. - Strong leadership, problem solving, and team development skills.

Benefits:

• Competitive salary
• Health, dental, and vision insurance
• Paid time off (PTO) and holidays
• Retirement plan with employer matching
• Continuing education and training opportunities
• A supportive and collaborative team environment
• Hours are 8A-5P.