Impact Advisors, LLC is a nationally recognized healthcare management consulting firm delivering Best in KLAS advisory, implementation, and optimization services. We are driven by a commitment to exceed client expectations and are proud to be a trusted partner to many of the nation's leading healthcare organizations. Our mission to drive patient-centered, value-driven outcomes has earned us prestigious industry accolades. To learn more about us, visit www.impact-advisors.com
Position Summary
The Billing Manager is responsible for leading and optimizing hospital and/or professional billing operations for a designated health system client within a Revenue Cycle Managed Services engagement. This role provides operational leadership for claim generation, billing edits, claim correction, claim submission, payer and clearinghouse acceptance, and billing-related work queues, ensuring claims are billed accurately and timely. This role is expected to own billing outcomes, proactively identify barriers, drive issues through resolution, and ensure work does not stall between teams or functions.
The Billing Manager will oversee day-to-day billing operations, manage performance against contractual service level agreements (SLAs), and work directly with client leadership to resolve barriers and improve billing performance. This position supports the primary client engagement and will be primarily remote with periodic client and internal leadership meetings. Occasional travel may be required to support client engagements, operational reviews, training, and strategic initiatives.
Key Responsibilities
Client Partnership & Operational Leadership
- Serve as the primary operational leader for billing services delivered to the assigned health system client.
- Build strong working relationships with Revenue Cycle, Finance, Patient Financial Services, and operational leaders.
- Lead regular operational reviews focused on performance, barriers, action plans, and improvement opportunities.
- Ensure alignment between client expectations, contractual obligations, and operational performance.
- Proactively identify risks and barriers and drive them through resolution.
- Own issues through resolution, escalating when needed while maintaining accountability for follow-through and outcome.
Billing Operations Management
- Oversee daily billing workflows including claim generation, billing edits, claim correction, claim submission, and clearinghouse/payer acceptance.
- Manage billing work queues, claim holds, edits, and other pre-bill exceptions.
- Ensure claims are submitted timely and accurately in accordance with payer and regulatory requirements.
- Drive billing errors, clearinghouse rejections, payer front-end rejections, and submission issues through resolution.
- Manage corrected claims and rebilling when billing-related changes are required.
- Identify recurring billing issues, determine root causes, and drive resolution across coding, revenue integrity, patient access, IT, and other teams as needed.
- Ensure accounts continue moving through the billing process and escalate barriers that prevent timely claim release.
- Maintain standardized billing workflows, procedures, and quality controls.
- Monitor unresolved billing inventory and ensure issues have clear ownership and follow-through.
Performance Management & Analytics
- Analyze and actively manage key billing performance metrics including: Clean claim and first-pass claim acceptance rates | Claim rejection rate | Billing lag / days to bill | Unbilled claim inventory | Billing edit and hold inventory / aging | Corrected claim / rebill volume | Late charge trends | Billing productivity and quality
- Identify performance gaps, determine root causes, and drive corrective actions through resolution.
- Use performance data to prioritize work, remove barriers, and hold the team accountable for results.
- Prepare and present operational performance and action plans to client and internal leadership.
- Leverage data to identify opportunities to improve billing accuracy, timeliness, and productivity.
Team Leadership
- Lead, coach, and develop billing supervisors, team leads, and billing specialists, including onshore and near-shore resources.
- Establish clear expectations for ownership, quality, productivity, and accountability.
- Conduct performance evaluations, coaching sessions, and staff development planning.
- Build a culture where team members solve problems, follow issues through resolution, and own the outcome.
- Coach team members to bring forward solutions, not simply identify or escalate problems.
- Support workforce planning, staffing, and resource allocation to meet client and operational needs.
Process Improvement & Transformation
- Identify recurring operational issues and drive improvements that address the root cause.
- Partner with technology, automation, and revenue cycle transformation teams to improve billing workflows.
- Look for opportunities to simplify work, reduce manual effort, and improve billing accuracy and productivity.
- Support system conversions, workflow redesign, and process standardization.
- Participate in client implementations, transitions, and service expansion initiatives as needed.
- Ensure improvements are implemented, measured, and sustained rather than stopping at recommendations.
Compliance & Risk Management
- Maintain compliance with HIPAA, regulatory requirements, payer guidelines, and organizational policies.
- Support billing audits and compliance reviews.
- Ensure appropriate billing controls, documentation, and quality monitoring are consistently followed.
- Identify compliance or billing risks early and drive corrective actions through resolution.
- Partner with compliance and revenue integrity teams to address identified issues and prevent recurrence.
Required Qualifications
- Bachelor’s degree in Healthcare Administration, Business Administration, Finance, Accounting, or related field; equivalent experience may be considered.
- 5+ years of progressive healthcare revenue cycle experience with a focus on hospital billing operations.
- 2+ years of leadership experience managing billing teams in a hospital, health system, business office, or revenue cycle outsourcing environment.
- Strong knowledge of hospital and professional billing, claim generation, billing edits, clearinghouse workflows, claim submission requirements, claim rejections, corrected claims, and payer billing requirements.
- Experience managing operational KPIs and developing performance improvement plans.
- Hands-on experience with Epic Hospital Billing (HB) and/or Professional Billing (PB), including billing work queues, claim edits, claim submission, and billing exception workflows.
- Demonstrated ability to take ownership of operational problems, work across functional boundaries, and drive issues through resolution.
- Demonstrated ability to manage client relationships and lead cross-functional initiatives.
- Proficiency with revenue cycle reporting tools, Microsoft Excel, and healthcare billing systems.
Preferred Qualifications
- Experience supporting managed services, outsourcing, or complex health system billing operations.
- Knowledge of both acute care and ambulatory billing operations.
- Experience with both Epic Hospital Billing (HB) and Professional Billing (PB).
- HFMA, CRCR, or other relevant revenue cycle certification.
- Experience presenting operational performance, risks, and improvement plans to client and executive leadership.
- Demonstrated success improving billing workflows, productivity, quality, or claim performance.
For salaried positions, this role may also be eligible for an annual performance bonus. Additional benefits and perks may also be available, depending on the position and employment terms. This range reflects consideration of several factors, including skills, experience, training, certifications, and organizational needs.
Our People and Culture
At Impact Advisors, we cultivate a caring, fun, honest, and autonomous work environment. Our success stems from our associates' dedication and a shared mission to create a “Positive Impact.” We embrace diversity and inclusion, fostering an environment where all employees feel valued and empowered.
Join Impact Advisors and make a real difference in healthcare.
