United States onlyWe 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.
