RCM, Billing Manager

VIVO Infusion - Billing Manager, Revenue Cycle

Location: Remote

Compensation:

• Pay Range: $93,000- $99,000/yr
• Bonus Plan Target: 10% Annually (Based on performance)
• Private Equity for the Greater Good - Company-wide Employee Ownership Program

Benefits:

• Medical, Dental, Vision
• HSA w/ Employer Contribution
  • Touchcare - Insurance Concierge Service
• 401K with Match up to 4%
• PTO: Accrual 3+ weeks
  • PTO Rollover and PTO Donation Program.
• Wellness Reimbursement Program - $360 Annually
• Employee Referral Bonus - Uncapped Bonus Potential
• Tuition Assistance Program & Professional Association Reimbursement
• Employee Assistance Program (Employer-provided)
• Short & long-term disability (Employer-provided)
• Life Insurance (Employer-provided)

Employment Type, Schedule, FLSA Status:

• Full-time
• Position Scheule:
  • Monday-Friday | 8:00am - 5:00pm
• Non-Exempt

Reports to: VP, Revenue Cycle Management

Location:

• The Billing Manager will work remotely from a home office with a secure network. Only candidates residing in the states below at the time of employment will be able to be considered. Travel with Vivo equipment is not permitted without prior approval.
  
  Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Wisconsin, Wyoming, Washington D.C.

Vivo Infusion is seeking an experienced Billing Manager who will lead the day-to-day billing operations, ensuring every patient encounter, including drug and administration charges, is captured, coded, and billed accurately, compliantly, and timely. The Manager oversees charge capture and entry, claim scrubbing and submission, clearinghouse edits and rejections and corrected claims. The Manager is accountable for the performance and productivity of the billing team, for key revenue cycle metrics and for implementing process improvements that increase cash flow and reduce rejections and denials. The Manager works closely with the Director of Revenue Cycle Management, clinic operations, providers, Patient Access, and medical policy to resolve billing barriers and drive operational excellence.

Primary Duties and Responsibilities:

• Leads, develops, and holds accountable a team of billing specialists to meet departmental goals; delegates effectively and demonstrates sound decision making.
• Oversees daily billing operations, including charge review and entry, reconciliation of charges to completed encounters, claim submission, and management of claim rejections and denials.
• Ensures timely and accurate submission of electronic (837P) and paper (CMS-1500) claims to commercial, government payers, and patients maintaining a 24-hour or less lag between date of service and claim submission.
• Ensures accurate billing of infusion services, including drug HCPCS (J-codes) with correct NDC, units, and wastage (JW/JZ modifiers), and drug administration CPT codes.
• Billing Rules and Automation: Oversees billing system edits, claim rules, and automated workflows; validates their accuracy through testing and ongoing monitoring.
• Manages clearinghouse claim edits, front-end rejections, and payer acknowledgment reports so that rejected claims are corrected and resubmitted within established timeframes and well within payer timely filing limits.
• Monitors and reports billing SMGs (time to bill, clean claim rate, first-pass resolution rate, rejection and denial rate) and leads month-end close activity and reporting.
• Analyzes clearinghouse rejections and denials to identify negative payer, coding, and data entry trends, and implements corrective action.
• Works with coding and compliance to ensure CPT, HCPCS, ICD-10-CM, and modifier usage is supported by documentation; coordinates provider education on documentation and charge capture issues.
• Establishes and manages Specific Measurable Goals (SMGs), productivity and quality standards, and workload assignments; maintains and standardizes billing policies, procedures, and workflows; troubleshoots and implements innovative solutions to achieve consistency and results.
• Acts as the primary billing contact for new systems and programs (practice management, clearinghouse, etc.), including testing, implementation, and ongoing oversight.
• Works collaboratively with Operations, Patient Access, Coding, Credentialing, Payor Contracting, Finance, and Patient Resource Operations to address business needs; engages with senior management on decisions that affect revenue.
• Maintains current knowledge of payer policies, reimbursement methodologies, and state and federal billing regulations (including CMS guidelines and HIPAA); supports internal and external audits.
• Promotes a culture of collaboration, integration, open communication, teamwork, and timely decision making between the billing team and other departments.
• Performs special projects and other duties as assigned.

Team Development

• Provides consistent and ongoing training for the billing team on payer rules, system workflows, and regulatory updates; conducts regular team meetings and provides suggestions for improvement and decision support.
• Plans, monitors, appraises, and reviews individual productivity and quality; conducts regular account audits and provides feedback; implements cross-functional training and succession planning as allowable.
• Ensures appropriate staffing levels and balance of workload for the billing team; coaches and counsels employees and delivers disciplinary action/PIP when needed.
• Supports a positive workplace culture to attract and retain billing talent.
• Hires, trains, disciplines, supervises, and motivates billing team members.

Education and Experience:

• High school graduate or equivalent required
• Professional certification preferred, such as Certified Professional Biller (CPB), Certified Professional Coder (CPC), Certified Revenue Cycle Representative (CRCR), or Certified Medical Reimbursement Specialist (CMRS)
• Minimum 3 years of healthcare billing experience, preferably in an infusion center or multi-specialty physician practice (CMS-1500 billing)
• Minimum 2 years of supervisory or management experience in a healthcare setting

Skills

• Advanced knowledge of medical billing including knowledge of medical insurance, accounting, HIPAA, Medicare/Medicaid, CPT, HCPCS, ICD-10 and HIPAA
• Experience in mentoring, coaching, and developing teams
• Excellent listening and influencing skills
• Proven attention to detail, with strong analytical, critical thinking, problem solving, and time management skills
• Strong interpersonal and communication skills to effectively navigate across the organization
• Demonstrated collaborative management style and strategic perspective.
• Proficient (intermediate level of application) with all Microsoft Office programs
• Prior experience working with sensitive and confidential information
• Minimal travel may be needed

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and ability needed. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Work environment and physical demands:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job.

The employee is frequently required to sit and infrequently required to stand, lift and/or move up to 25 pounds. While performing the duties of this job, the employee is required to sit, stand; walk and talk, climb stairs, and hear. Requires excellent visual dexterity and manual dexterity. The noise level in the work environment is usually low to moderate.