Medical Billing Manager

Description

We are seeking a knowledgeable and collaborative Medical Billing Manager to serve as our CPT Subject Matter Expert (SME) and act as a key liaison between our internal teams and partner medical practices. This role will lead efforts in analyzing billing trends, addressing claim denials, and providing education and support to users of our software regarding best practices in coding and billing compliance.Responsibilities:

Serve as the company’s go-to expert on CPT coding and act as a strategic partner to medical practices using our platform.
Collaborate with practices to analyze and resolve claim denials, coding discrepancies, and billing challenges.
Provide expert guidance on medical billing processes, including correct usage of ICD-10, CPT, and/or HCPCS coding systems.
Provide specialized support for billing related to chronic care management (CCM), principal care management (PCM), remote patient monitoring (RPM), and other value-based care programs.
Maintain a deep understanding of insurance claim forms and processes (e.g., CMS-1500, UB-04).
Prepare and present regular reports summarizing revenue cycles, outstanding balances, denial trends, and other billing metrics to support operational decisions.
Monitor changes in healthcare billing regulations and payer requirements to ensure our practices and platform stay compliant.
Partner with product and engineering teams to provide insights on billing workflows and contribute to continuous improvement of our software.
Conduct training sessions or create resource materials to educate clients and internal teams on proper coding, documentation, and billing best practices.

Requirements

Bachelor’s degree in Healthcare Administration, Business, or related field (or equivalent work experience).
5+ years of experience in medical billing, revenue cycle management, or practice operations.
Deep expertise in CPT, ICD-10, and HCPCS coding systems.
Proven experience with CCM, PCM, RPM, and other time-based or care coordination codes strongly preferred.
Familiarity with CMS-1500 and UB-04 claim forms.
Strong analytical skills and comfort working with data to inform business decisions.
Experience supporting or working within a healthcare software environment is highly desirable.
Excellent communication and relationship-building skills with the ability to explain complex billing topics to both technical and non-technical audiences.

Benefits

WORKING AT VATICA HEALTH ADVANTAGES

Prosperity

Competitive salary based on your experience and skills – we believe the top talent deserves the top dollar
Bonus Potential (based on role and is discretionary) – if you go above and beyond, you should be rewarded
401k plans– we want to empower you to prepare for your future
Room for growth and advancement- we love our employees and want to develop within

Good Health

Comprehensive Medical, Dental, and Vision insurance plans
Tax-free Dependent Care Account
Life insurance, short-term, and long-term disability

Happiness

Excellent PTO policy (everyone deserves a vacation now and then)
Great work-life balance environment- We believe family comes first!
Strong supportive teams- There is always a helping hand when you need it

The salary for a position is typically determined by multiple factors such as the individual's qualifications, experience, skills, and location. The projected compensation range for the position may vary based on these factors and could range from $60,000 to $80,000 (annualized USD). However, this estimate represents just one aspect of our total compensation package offered.

Life at Vatica Health

Vatica Health is a leading services and technology company that improves payer and provider performance in value-based care. We connect healthcare stakeholders to optimize quality and manage risk. Our clinical experts leverage our proprietary technology to seamlessly integrate into the provider office workflow. By removing the technical and administrative burdens associated with value-based care, we put the doctor back in the driver's seat. Our clinical documentation is compliant with today's increasingly complex regulations and enhances risk-adjusted reimbursements, lowers audit risk and improves quality of care. Our differentiated approach to risk adjustment and quality drives increased member and provider engagement. By completing the Last Mile of value-based care, Vatica Health delivers the future of healthcare today. The Problem: Payers and other at-risk entities lack effective means to capture complete and accurate risk scores and improve quality measures for the majority of their members across all business lines. Providers lack the space, the staff and patient engagement to effectively improve the cost and quality of care. Our Solution: Vatica Health pioneered the delivery of the industry's first Provider-centric, Risk Adjustment and Quality (PRAQTM) solution that measures and improves quality of care, provider and payer financial performance, and overall population health. Working at Vatica Health: We are seeking smart, hands-on, driven, collaborative team players with a thirst for learning and innovating. We leverage state-of-the-art technology to communicate, collaborate and get work done - fast. If you have an entrepreneurial spirit and a passion for producing amazing work that measurably impacts our industry, we want to talk with you. Connect with Vatica Health on Twitter @VaticaHealth. Specialties: Risk Adjustment, Value-based Care, Clinical and Quality Outcomes, Claims and Payment Integrity, Healthcare Data insights, Quality Improvement, Risk core Accuracy, Annual Wellness Visit, Medicare, CMS Star Ratings, NCQA, HEDIS, QRS, ICD-10, Cloud, Big Data

Thrive Here & What We Value* Empowerment and Growth Opportunities* Competitive Compensation Structure* WorkLife Balance Emphasis* Supportive Team Environment* Comprehensive Benefits Package (Healthcare, Insurance Plans, Retirement Savings)