Position Summary
***This is not a remote position***
The Billing Manager is responsible for overseeing and optimizing all revenue cycle activities for our orthopedic clinic, American Hip Institute, and ambulatory surgery center (ASC), Greater Chicago Center for Advanced Surgery. This role serves as the primary liaison between internal clinical/administrative teams and our external billing service, ensuring accurate charge capture, timely claims submission, effective accounts receivable management, and compliance with payer and regulatory requirements. The ideal candidate brings experience in medical billing, orthopedic or surgical specialties, and strong leadership in managing cross‑functional revenue cycle activities.
Key Responsibilities
Revenue Cycle Oversight
- Lead and manage the revenue cycle process including charge capture, coding accuracy, claims submission, payment posting, denials management, and collections.
- Monitor accounts receivable trends, reimbursement patterns, adjustments, and aging to ensure financial performance aligns with organizational goals.
- Review and refine workflows with the external billing service to ensure alignment, transparency, and accountability.
Collaboration & Communication
- Serve as the main point of contact for the external billing service; conduct regular meetings, monitor KPIs, escalate issues, and ensure service-level adherence.
- Work closely with physicians, leadership, clinical teams, and administrative staff to ensure documentation clarity and timely submission of billing information.
- Educate internal teams on documentation requirements, billing changes, and payer updates.
- This role reports directly to the CEO and works in close collaboration with them on revenue cycle workflow improvements and external billing vendor performance
Compliance & Quality Assurance
- Ensure compliance with federal, state, and payer-specific regulations, including Medicare, commercial payers, and workers' compensation.
- Maintain up‑to‑date knowledge of CPT, ICD‑10, HCPCS, ASC billing requirements, modifiers, global periods, and orthopedic-specific coding standards.
- Implement internal audits of coding, documentation, and claim activity; lead corrective action initiatives for identified deficiencies.
Reporting & Analytics
- Develop, analyze, and present revenue cycle performance reports for leadership.
- Track KPIs including days in A/R, clean claim rate, denial rate, net collection rate, and charge lag.
- Identify trends in denials, reimbursement, and payer behavior; coordinate solutions with external billing service and internal staff.
Leadership & Process Improvement
- Provide oversight and direction to any internal billing support staff (if applicable).
- Manage and refine billing workflows within the clinic and ASC to increase efficiency and reduce errors.
- Partner with IT and operations to optimize practice management and EHR system usage.
Qualifications
- Bachelor’s degree in healthcare administration, business, finance, or related field preferred.
- 3–5+ years of medical billing or revenue cycle experience, preferably in orthopedic.
- Experience working with ASCs and external billing vendors strongly preferred.
- Deep knowledge of medical coding, CPT/ICD‑10, insurance reimbursement, and payor rules.
- Strong analytical, organizational, and problem‑solving skills.
- Excellent communication skills for cross‑departmental and external vendor collaboration.
- Experience with practice management systems and EHR platforms commonly used in orthopedic/ASC settings.
Competencies
- Leadership & Accountability: Ability to coordinate across teams and enforce billing standards.
- Technical Expertise: Strong understanding of orthopedic procedures, surgical billing, and ASC reimbursement.
- Strategic Thinking: Ability to identify revenue cycle improvement opportunities and implement solutions.
- Vendor Management: Skilled in managing expectations, performance, and workflows with third‑party billing services.
- Adaptability: Able to adjust quickly to payer changes, regulatory updates, or operational needs.
Why This Role Matters
This position is central to ensuring the financial health of both the orthopedic clinic and the ASC. By seamlessly integrating internal workflows with the external billing partner and ensuring accuracy at every stage of the revenue cycle, the Billing Manager helps maintain strong cash flow, compliance, and patient satisfaction.
Pay: $62,000.00 - $75,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Experience:
- Medical billing: 3 years (Required)
Work Location: In person
