ReKlame Health

Medical Billing Manager

ReKlame Health

full-time

Posted on:

Location Type: Remote

Location: Remote • 🇵🇰 Pakistan

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Job Level

Mid-LevelSenior

About the role

  • Lead and oversee all aspects of the billing process, including claims submission, payment processing, and account reconciliation, ensuring accuracy and efficiency.
  • Ensure accurate, compliant coding with ICD-10, CPT, and HCPCS systems to optimize first-pass claim submissions and maximize revenue for patient care and procedures.
  • Establish scalable workflows to address multi-state billing complexities, with a focus on state-specific Medicaid requirements and streamlined reimbursements.
  • Monitor and implement changes in Medicare, Medicaid, and other regulatory guidelines, ensuring full compliance across all billing and coding processes.
  • Conduct regular audits to uphold coding standards, identify gaps, and ensure accurate documentation and billing practices.
  • Partner with providers, administrative teams, and payers to address documentation gaps, efficiently resolve coding challenges, and reduce claim denials.
  • Identify skill gaps and develop tailored training initiatives, such as workshops, coaching sessions, and resource playbooks, to enhance team capabilities.
  • Serve as the expert in coding and billing complexities, particularly in navigating multi-state Medicaid and Medicare nuances.
  • Leverage emerging technologies and automation tools to optimize billing operations, enhance team performance, and support long-term cost efficiency.

Requirements

  • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification in medical coding is mandatory.
  • Minimum of 3-5 years of professional experience in medical coding and billing, including expertise with Medicare and Medicaid systems.
  • Strong preference for candidates with experience in behavioral health coding.
  • Demonstrated experience leading and mentoring a team, with a history of improving performance and operational workflows.
  • Advanced proficiency with ICD-10, CPT, and HCPCS coding systems and experience with EHR and medical billing software.
  • Exceptional accuracy and attention to detail in coding/billing and documentation.
  • Strong understanding of HIPAA and healthcare compliance guidelines, with the ability to adapt to changing regulations.
  • Exceptional written and verbal communication abilities to effectively collaborate with stakeholders at all levels.
  • Analytical mindset with the ability to address complex challenges, identify solutions, and implement improvements with speed and accuracy.
Benefits
  • Health insurance
  • Paid time off
  • Remote work options

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
ICD-10CPTHCPCSmedical codingbillingclaims submissionpayment processingaccount reconciliationbehavioral health codingEHR
Soft skills
leadershipmentoringattention to detailcommunicationanalytical mindsetproblem-solvingcollaborationtraining developmentperformance improvementadaptability
Certifications
Certified Professional Coder (CPC)Certified Coding Specialist (CCS)