Job Description

We are seeking a knowledgeable and collaborative Medical Billing Manager to serve as our CPT Subject Matter Expert (SME) and act as a key liaison between our internal teams and partner medical practices. This role will lead efforts in analyzing billing trends, addressing claim denials, and providing education and support to users of our software regarding best practices in coding and billing compliance.

Responsibilities:

• Serve as the company’s go-to expert on CPT coding and act as a strategic partner to medical practices using our platform. 

• Collaborate with practices to analyze and resolve claim denials, coding discrepancies, and billing challenges. 

• Provide expert guidance on medical billing processes, including correct usage of ICD-10, CPT, and/or HCPCS coding systems. 

• Provide specialized support for billing related to chronic care management (CCM), principal care management (PCM), remote patient monitoring (RPM), and other value-based care programs. 

• Maintain a deep understanding of insurance claim forms and processes (e.g., CMS-1500, UB-04). 

• Prepare and present regular reports summarizing revenue cycles, outstanding balances, denial trends, and other billing metrics to support operational decisions. 

• Monitor changes in healthcare billing regulations and payer requirements to ensure our practices and platform stay compliant. 

• Partner with product and engineering teams to provide insights on billing workflows and contribute to continuous improvement of our software. 

• Conduct training sessions or create resource materials to educate clients and internal teams on proper coding, documentation, and billing best practices. 

• Perform a variety of administrative tasks in support of the day-to-day operations of the Operations Team 

• Work closely with Operations Coordinators to process Jira tickets submitted to the queues managed by the Operations Team 

• Prioritize client needs; manage expectations, handle matters expeditiously, proactively, and follow-through on assigned tasks

• Supports Clinical Operations in the execution of various key organizational objectives and projects. Productivity for these projects will be determined on a case-by-case basis.

Requirements

• Bachelor’s degree in Healthcare Administration, Business, or related field (or equivalent work experience). 

• 5+ years of experience in medical billing, revenue cycle management, or practice operations. 

• Deep expertise in CPT, ICD-10, and HCPCS coding systems. 

• Proven experience with CCM, PCM, RPM, and other time-based or care coordination codes strongly preferred. 

• Familiarity with CMS-1500 and UB-04 claim forms. 

• Strong analytical skills and comfort working with data to inform business decisions. 

• Experience supporting or working within a healthcare software environment is highly desirable. 

• Excellent communication and relationship-building skills with the ability to explain complex billing topics to both technical and non-technical audiences. 

• Persistence, strong ability to organize, prioritize, and work independently within the construct of a team. 

Competencies:  

Action Oriented 

• Taking on new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm.

• Identifies and seizes new opportunities. 

Collaborates 

• Identifies and builds partnerships to meet shared goals.

• Readily partners with others to meet objectives and shares credit for contributions.

• Demonstrates cooperation that earns support of others. 

 Communicates Effectively 

• Exchanging ideas, knowledge, and data so that the message is received and understood with clarity and purpose.

• Leverages emotional intelligence to adapt to the emotions and intentions of others. 

Nimble Learning 

• Active approach to learning using both successes and failures as opportunities.

• Seeks knowledge and resources, takes on new challenges, and experiments with new solutions. 

Situational Adaptability & Flexibility 

• Adapts approach in real time to respond to different situations.

• Thinks quickly and readily adapts behavior in the moment.

• High level of versatility. 

Customer Focus 

• Builds strong internal and external customer relationships and prioritizes customer-centric solutions.

• Identifies opportunities to serve customers and stakeholders more effectively. 

Benefits

WORKING AT VATICA HEALTH ADVANTAGES

Prosperity

• Competitive salary based on your experience and skills – we believe the top talent deserves the top dollar
• Bonus Potential (based on role and is discretionary) – if you go above and beyond, you should be rewarded
• 401k plans– we want to empower you to prepare for your future
• Room for growth and advancement- we love our employees and want to develop within

Good Health

• Comprehensive Medical, Dental, and Vision insurance plans
• Tax-free Dependent Care Account
• Life insurance, short-term, and long-term disability

Happiness

• Excellent PTO policy (everyone deserves a vacation now and then)
• Great work-life balance environment- We believe family comes first!
• Strong supportive teams- There is always a helping hand when you need it

The salary for a position is typically determined by multiple factors such as the individual's qualifications, experience, skills, and location. The projected compensation range for the position may vary based on these factors and could range from $60,000 to $80,000 (annualized USD). However, this estimate represents just one aspect of our total compensation package offered.

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