Job Details

The Billing Manager is responsible for overseeing all billing, coding, and revenue cycle operations for the ophthalmology clinic. This role ensures accurate claim submission, timely reimbursement, compliance with regulatory requirements, and the effective management of billing staff. The ideal candidate will have strong leadership skills, attention to detail, and experience in medical billing specific to ophthalmology or related specialties.

Key Responsibilities

• Oversee daily operations of the billing department, including coding, charge entry, claim submission, payment posting, and collections.
• Supervise, train, and evaluate billing staff to ensure accuracy, productivity, and compliance with clinic policies.
• Ensure all billing and coding practices comply with federal, state, and payer-specific guidelines.
• Monitor accounts receivable, denial trends, and reimbursement patterns; implement corrective actions to optimize revenue cycle performance.
• Collaborate with providers, technicians, and administrative staff to resolve billing issues and improve documentation quality.
• Develop and maintain reporting systems to track key revenue cycle metrics (e.g., days in A/R, clean claim rate, denial rate).
• Serve as the primary liaison with insurance companies, clearinghouses, and patients regarding billing and coding issues.
• Stay updated on ophthalmology-specific coding changes, payer requirements, and compliance regulations.

• Required: Current certification as a Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding credential.
• Associate or bachelor's degree in healthcare administration, business, or related field preferred.
• Minimum of 3-5 years of medical billing experience, with at least 2 years in a supervisory or management role.
• Prior experience in ophthalmology, optometry, or other specialty medical practices strongly preferred.
• Knowledge of medical terminology, CPT/ICD-10 coding, and payer reimbursement policies.
• Proficiency in practice management and electronic health record (EHR) systems.
• Strong leadership, organizational, and communication skills.