Medical Billing Manager

Credense Medical Billing Pvt. Ltd. is seeking an experienced Manager to lead day-shift medical billing operations. The Manager will be accountable for team performance, billing quality, collections, SLA compliance, and coordination with the night-shift manager.

Key Responsibilities

• Oversee daily operations across claim submission, payment posting, denial management, AR follow-up, and related billing processes.
• Set targets for team leads and staff, review completed work, and address missed targets or quality issues promptly.
• Own compliance with client and internal SLAs, including turnaround times for claims, payment posting, denials, AR follow-up, client requests, and issue resolution.
• Track approaching SLA deadlines, assign clear owners, and escalate risks before deadlines are missed. Investigate breaches and verify that corrective actions are completed.
• Coordinate daily with the night-shift manager on pending work, client priorities, approaching deadlines, escalations, and handoffs between shifts.
• Monitor collections, outstanding AR, denial rates, clean claim rates, productivity, quality, and turnaround times.
• Provide daily updates on targets, completed work, backlogs, SLA risks, and urgent issues.
• Prepare a weekly performance report for senior management covering results against targets, SLA compliance and breaches, AR and denial trends, client issues, staffing and attendance, corrective actions, and priorities for the following week.
• Review reports and work queues to identify missed claims, unposted payments, unresolved denials, and other operational gaps. Assign owners and follow through to resolution.
• Handle client and internal escalations, working with the night-shift manager and other departments as needed.
• Conduct team reviews, coaching, training, and performance evaluations.
• Improve workflows to increase collections, reduce outstanding AR and denials, and prevent work from being missed between shifts.
• Maintain SOPs and process documentation, support audits, and ensure compliance with client requirements and applicable healthcare billing rules.
• Participate in client meetings and business reviews when required.

Required Qualifications

• At least 10 years of experience in US medical billing or healthcare revenue cycle management.
• At least 2 years in a Manager role, with the designation reflected in official employment records.
• Hands-on knowledge of claims, AR, denials, payment posting, eligibility, and insurance follow-up.
• Proven experience managing multiple teams, monitoring SLAs, and using performance reports to improve results.
• Strong leadership, analytical, problem-solving, and communication skills.
• Ability to coordinate across shifts and hold teams accountable for deadlines and quality.
• Experience handling client escalations and management-level discussions.
• Proficiency in Microsoft Excel and experience with reporting or analytics tools are required.

Preferred Experience

• Hands-on experience with NextGen and eClinicalWorks (eCW).