Medical Billing & Coding Manager

Position Summary

The Medical Billing & Coding Manager oversees the accuracy, compliance, and financial performance of the facility’s revenue cycle in the ambulatory surgery center setting. This role is responsible for auditing and managing the facility’s billing and/or billing vendors, monitoring revenue cycle performance, and providing oversight of the center’s budget and spending. The Medical Billing & Coding Manager serves as the primary financial liaison between the surgery center, its billing partners, payers, clinical staff, and providers, and supports administration and ownership with financial reporting and planning. This position offers the opportunity for growth into a senior financial leadership role.

Essential Duties and Responsibilities

Coding & Billing Oversight

• Conduct regular audits of third-party coding and billing work for accuracy, completeness, and compliance with CPT, ICD-10-CM, and HCPCS guidelines.
• Review operative reports and clinical documentation to validate code assignment and provide documentation feedback to physicians as appropriate.
• Monitor vendor performance against contractual service-level agreements and report results to administration.
• Serve as primary liaison between the surgery center, third-party coders and billers, payers, and physicians on coding and billing matters.

Revenue Cycle Management

• Monitor key revenue cycle metrics, including days in accounts receivable, clean claim rate, denial rate, and net collection rate.
• Ensure complete charge capture, reconcile charges, payments, and adjustments, and verify payments against contracted rates to identify underpayments.
• Oversee patient statements, payment plans, and collections in accordance with facility policy.

Financial Oversight & Budgeting

• Develop, monitor, and manage the annual operating budget in collaboration with administration.
• Review and approve expenditures within delegated authority; track spending against budget and report variances.
• Prepare monthly financial and revenue cycle reports for administration, ownership, and the governing body.
• Support financial forecasting, strategic planning, and cost-containment initiatives.

Compliance Responsibilities

• Ensure coding and billing practices comply with CMS, Medicare, Medicaid, commercial payer, and HIPAA requirements.
• Stay current on annual CPT, ICD-10-CM, and HCPCS updates and CMS ASC payment rule changes; communicate their impact to vendors and staff.
• Assist with payer audits, external audits, and records requests.
• Maintain billing and coding policies and procedures and ensure they are reviewed and updated as required.

General Responsibilities

• Adhere to AAAHC, CMS, and facility policies and procedures.
• Participate in quality assurance and quality improvement initiatives.
• Maintain strict confidentiality and complete documentation accurately and timely.
• Demonstrate professional communication with patients, families, physicians, vendors, and staff.
• Participate in orientation, competency validation, continuing education, and in-services.
• Perform other duties as assigned.

Qualifications

Required

• High school diploma or equivalent
• Current coding certification (CPC, COC, CCS, or equivalent) through AAPC or AHIMA
• Minimum 3 years of medical billing and coding experience in an orthopedic ambulatory surgery center
• Thorough knowledge of CPT, ICD-10-CM, HCPCS, and modifier usage
• Working knowledge of Medicare, Medicaid, and commercial payer billing rules
• Proficiency with practice management and billing software and Microsoft Excel
• Strong analytical, organizational, and communication skills

Preferred

• Degree in finance, accounting, health information management, or healthcare administration
• Experience with budgeting, financial reporting, or accounts payable oversight
• Revenue cycle or healthcare finance credential (CRCR, CHFP, or equivalent)
• Experience managing outsourced billing or coding vendors

Supervision Received

Administrator or designee – Administrative supervision

Physical Requirements

• Prolonged sitting and extended computer use
• Manual dexterity for keyboard and office equipment use
• Occasional lifting and moving of files and office supplies
• Physically capable of listening
• Physically capable of reading and reviewing written communications and financial reports

Pay: $85,000.00 - $92,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Retirement plan
• Vision insurance

Work Location: In person