Medical Billing Manager

The Billing Manager oversees and manages all billing operations for the oncology practice. This role serves as the primary liaison to the billing company; however, the primary responsibility is full managerial oversight of the revenue cycle, including charge capture, claims accuracy, payer relationships, contract management, and reimbursement optimization. The Billing Manager must have advanced knowledge of oncology billing-including chemotherapy, biologics, supportive care, infusion hierarchy, and payer-specific policies-and must be able to strengthen the revenue cycle through leadership, strategic analysis, and contract negotiation. Essential Duties and Responsibilities Revenue Cycle Leadership & Oversight Serve as the Billing Manager, overseeing all billing functions, performance standards, and workflow execution. Monitor daily revenue cycle operations, ensuring complete and accurate charge capture for oncology and chemotherapy services. Oversee AR performance, collections, underpayments, denials, and reimbursement trends. Lead performance expectations for both internal staff and the billing company. Contract Review, Analysis & Negotiation Review and analyze existing payer contracts, DOFRs, fee schedules, carve-outs, and reimbursement methodologies. Identify opportunities to negotiate improved reimbursement rates and terms with insurance companies. Track payer performance, reimbursement discrepancies, and underpayments to support negotiations. Maintain an updated understanding of payer requirements, contract updates, and oncology coverage policies. Liaison to Billing Company Serve as the operational link between the clinic and the billing company to ensure transparency, accountability, and timely resolution of issues. Communicate expectations clearly and ensure follow-through on billing concerns, appeals, and corrective actions. Oncology Billing Expertise Review all chemotherapy, immunotherapy, targeted therapy, supportive infusions, and injection claims for coding accuracy and compliance. Research and resolve payer denials involving medical necessity, prior authorization, bundling edits, and chemotherapy-specific requirements. Ensure accurate billing of drug units, NDCs, waste, J-codes, Q-codes, and oncology-specific HCPCS codes. Process Improvement & Compliance Develop improved workflows and protocols to strengthen billing accuracy and revenue integrity. Train clinical and administrative staff on documentation requirements and charge capture workflows. Ensure compliance with Medicare, Medicaid, commercial payer rules, and oncology billing guidelines. Reporting & Accountability Provide regular reports to leadership on AR status, reimbursement trends, contract variances, and performance benchmarks. Recommend strategic improvements to increase revenue and reduce preventable denials. Qualifications Minimum 5 years of medical billing or revenue cycle experience, including managerial or supervisory responsibility. Strong expertise in oncology revenue cycle operations, chemotherapy billing, infusion hierarchy, and payer-specific oncology requirements. Demonstrated experience reviewing, analyzing, and negotiating insurance contracts to improve reimbursement. Strong analytical and financial modeling skills. Associate's degree required; Bachelor's degree in Healthcare, Business, or a related field strongly preferred and Essential Professional Certifications Advanced knowledge of CPT, ICD-10, HCPCS, payer contracts, DOFRs, and oncology billing rules. Excellent leadership, communication, and problem-solving skills. Job Type: Full-time Benefits: Dental insurance Health insurance Paid time off Vision insurance Application Question(s): How many years of Oncology experience do you have? Experience: ICD-10: 5 years (Required) Compensation / Pay Rate (Up to): $25.00 - $30.00

Created: 2026-03-04