The Billing Manager oversees the full revenue cycle operations for a high-volume, multi-location retina practice in New York City. This role is responsible for leading the billing and AR department, ensuring accurate and timely claims submission, optimizing collections, and maintaining compliance with payer and regulatory requirements. The ideal candidate has deep experience in ophthalmology/retina billing, strong knowledge of Medicare billing rules and reimbursement, advanced analytical and reporting skills, and the ability to synthesize complex data into actionable insights for leadership.
Key Responsibilities
- Lead and manage the billing, AR, and collections teams across multiple practice locations.
- Oversee full revenue cycle operations including charge capture, coding accuracy, claims submission, payment posting, denials management, and appeals.
- Manage drug AR, including tracking high-cost retina pharmaceuticals, reconciling buy-and-bill inventory, and ensuring accurate reimbursement.
- Oversee inventory processes related to retina injectables and surgical supplies, ensuring alignment between clinical usage, billing, and purchasing.
- Direct and maintain credentialing and re-credentialing for all providers with commercial payers, Medicare, Medicaid, and managed care plans.
- Monitor AR aging, establish performance benchmarks, and implement corrective action plans to reduce outstanding balances.
- Develop and maintain dashboards, KPIs, and financial reports for leadership; provide clear data synthesis, forecasting, and projections to support operational and strategic decisions.
- Conduct root-cause analysis on denials, underpayments, and payer trends; implement process improvements to maximize revenue.
- Ensure compliance with HIPAA, payer policies, Medicare billing guidelines, and retina-specific coding requirements.
- Collaborate closely with clinical, administrative, and operational leadership to streamline workflows and support practice growth.
- Train, mentor, and evaluate billing staff; establish accountability and performance standards.
Qualifications
- 5+ years of medical billing experience, preferably in ophthalmology or retina.
- Strong knowledge of Medicare billing, coverage policies, and reimbursement methodologies.
- Deep understanding of retina-specific coding (e.g., injections, imaging, procedures) and buy-and-bill reimbursement.
- Proven experience managing multi-site billing operations.
- Exceptional analytical skills with the ability to interpret data, build reports, and forecast trends.
- Proficiency in EMR/EHR and practice management systems; experience with reporting tools preferred.
- Strong leadership, communication, and problem-solving abilities.
- Ability to thrive in a fast-paced, high-volume environment.
Salary: $85,000-$95,000, commensurate with experience
Pay: $85,000.00 - $95,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Parental leave
- Retirement plan
- Vision insurance
Work Location: In person
