Salary
💰 $55,000 - $65,000 per year
About the role
- Manage and develop the Member Bills and Reimbursement team
- Set performance goals, oversee team structure, and monitor workload
- Lead team meetings and ensure compliance with changing plan guidelines
- Oversee the full lifecycle of medical billing submissions and reimbursements
- Ensure SOPs are followed for claims processing, receipts, virtual card payments, and more
- Conduct audits and ensure compliance with plan benefits and regulatory requirements
- Support members directly with escalated billing issues and communicate timelines with clarity and empathy
- Identify opportunities to improve processes and prevent repeat issues
- Work closely with internal teams like TPA, Complex Claims, and Care Logistics to ensure clean handoffs and timely resolutions
- Track and improve performance using KPIs like Speed to Closure and Clean Claim Rate; report on trends and lead improvement initiatives across the department
Requirements
- 5+ years in a supervisory or managerial role
- Experience in healthcare billing, reimbursement, or claims (strongly preferred)
- Proven leadership skills and operational excellence
- Customer-first mindset and love for solving complex issues
- Strong communication, analytical thinking, and a hands-on approach