Billing Specialist

• Oversee the billing operations for hospital/professional services.
• Coordinate and manage the revenue cycle functions, including but not limited to billing, insurance follow up, cash application, patient credit balances, denial management, mail, scanning, data entry and other miscellaneous functions.
• Provide direction and support to staff, promote staff development and collaborate with other managers, directors and administrative staff to ensure operations function in a safe, effective, and fiscally responsible manner.
• Monitor key metrics and reports to ensure all activities are completed by staff timely and accurately.
• Monitor and interpret reports, including denial reports, monthly A/R reports and all other reports as necessary.
• Ensure the accuracy of net revenue and the timeliness and appropriateness of billing and collections.
• Conduct quality and productivity reviews of staff members and provide feedback on performance.
• Participate in the hiring and disciplining of staff members.
• Organize, schedule, and supervise staff to ensure adequate coverage, as well as prompt responses to issues, concerns, and/or complaints.

Billing and AR Follow-up Manager

• Directly oversee professional coding operations.
• Ensure accurate CPT, HCPCS, and ICD-10 coding in accordance with payer and regulatory guidelines.
• Monitor coding productivity and quality on a daily and weekly basis.
• Conduct routine internal audits and address coding variances promptly.
• Lead corrective action plans when audit results fall below target thresholds.
• Stay current with CMS, payer, and specialty-specific coding updates.
• Oversee timely and accurate charge entry for all clinical services.
• Monitor lag days from date of service to claim submission.
• Identify and resolve missing charges, interface errors, and documentation gaps.
• Implement controls to reduce unbilled inventory and prevent revenue leakage.
• Validate modifiers and ensure compliance with payer-specific billing rules.
• Review work queues and charge edit reports daily.
• Intervene directly in complex or high-risk coding scenarios.
• Participate in denial root cause reviews related to coding or charge capture.
• Collaborate with AR leadership to address downcoding, bundling, and medical necessity denials.
• Monitor and reduce coding-related denial rates.
• Conduct detailed vendor performance reviews, including QC results and productivity tracking.
• Escalate deficiencies and require documented remediation plans.
• Participate directly in operational calls to review aging, denials, and backlog.
• Evaluate cost effectiveness and recommend insourcing when appropriate.
• Directly manage coding supervisors, leads, and charge entry staff.
• Set clear productivity and accuracy expectations.
• Conduct performance reviews and coaching sessions.
• Provide ongoing education and specialty-specific training.
• Develop high-performing coders with expertise in complex surgical and procedural coding (if applicable).
• Partner with physicians and practice leadership to improve documentation quality.
• Work closely with Revenue Cycle leadership to improve clean claim rates.
• Collaborate with IT on system edits, charge interfaces, and automation.
• Support new service lines and acquisitions with coding setup and charge master validation.
• Track and report on key performance indicators: Coding accuracy rate, Productivity benchmarks, Charge lag days, Coding-related denial rate, Unbilled inventory.
• Provide monthly reporting and operational improvement plans to RCM leadership.

Associate Director – Billing, Coding

• Following standard operating procedures, this role is responsible for analyzing a portfolio of National Account customers with low to medium complexity revenue clients
• Analysis of billing transactions & processes to understand trends ensuring completeness and accuracy
• Provides proper review and management of unbilled charges.
• Interacts with customers or other division staff/management to resolve billing discrepancies.
• Communicates effectively with internal and external customers via all channels
• Assists peers with Analysis of client audits where required to meet billing timelines
• Performs detailed client audit reviews upon request.
• Processes uploads for 3rd party portal invoices in a timely manner to ensure prompt payment for various clients.
• Coordinates with billing team to provide guidance, direction & feedback.
• Complies with all applicable Sarbanes Oxley (SOX) requirements for audit reviews.
• Collaborates and partners with peers to support goals and team cohesiveness.
• Completes special projects as assigned or needed.
• Understanding of vendor invoicing (WM and 3rd party) and reconciliation.
• Maintains a focus on overall quality of work.

Billing Specialist jobs in Connecticut

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Billing and AR Follow-up Manager

Associate Director – Billing, Coding

Billing Representative