JOB FUNCTION

Onsite leadership role overseeing the revenue cycle for a large, multi-location private orthopedic practice, including its orthopedic surgery, rehabilitation (physical and occupational therapy), durable medical equipment (DME), and radiology/imaging service lines. This role manages the accounts receivable department responsible for billing and collections across all clinic locations, and creates, generates, and maintains reporting dashboards on clinic and service-line financial performance for physician partners and key stakeholders.

ESSENTIAL FUNCTIONS

Demonstrate strong leadership skills through training, supervision, coaching, and mentoring of billing and collections staff across multiple clinic locations and service lines. Develop and implement standardized billing procedures across all clinic locations, working with clinic managers and service-line leaders (orthopedics, rehab/therapy, and radiology) to ensure proper collection of demographic, insurance, and billing information. Delegate and assign work to revenue cycle staff for billing across orthopedic, rehab/therapy, DME, and radiology service lines. Establish and maintain internal controls related to billing and collections, working closely with the Director of Finance. Maintain compliance with all federal, state, and local billing and coding guidelines, including payer-specific requirements for orthopedic surgery, physical/occupational therapy (e.g., therapy caps, modifiers), DME, and diagnostic imaging/radiology services. Be proficient in practice management and EHR billing software systems used across clinic locations; learn and utilize the practice's EMR revenue cycle management system to optimize billing, claims submission, and reporting workflows. Work with the accounting department to reconcile accounts receivable and contractual write-offs on a monthly basis across all locations and service lines. Establish and maintain best-practice benchmark metrics (e.g., days in AR, clean claim rate, denial rate, net collection rate) to demonstrate departmental performance across the practice. Oversee insurance verification, prior authorization, and denial management processes for surgical procedures, imaging studies, and therapy services. Represent the department and the organization at cross-departmental and physician leadership meetings. Recruit, train, and retain revenue cycle staff across all clinic locations.

ADDITIONAL RESPONSIBILITIES

Resolve patient problems related to their account balances across all clinic locations. Create and maintain standardized policies and procedures for the billing department across the practice. Ensure cross-training across all areas of revenue cycle operations, including orthopedic, rehab, DME, and radiology billing workflows. Maintain monthly and quarterly key performance indicators by clinic location and service line. Compile financial reports as requested by practice leadership and physician partners. Manage relationships with clearinghouses, payers, and outside collection agencies as needed.

QUALIFICATIONS

Experience:

Minimum of five years of experience in physician billing and collections, ideally including orthopedic, rehabilitation/therapy, DME, and radiology/imaging billing. Minimum of three years of supervisory or management experience, preferably across multiple clinic locations. Working knowledge of CPT, HCPCS, ICD-10, and modifier requirements relevant to orthopedic surgery, physical/occupational therapy, DME, and diagnostic imaging. Experience learning and utilizing EMR/practice management revenue cycle management modules preferred. Strong interpersonal and communication skills.

Licensing/Education:

Bachelor's Degree in Business, Accounting, Finance, Healthcare Administration, or related experience. Certified coding credential (e.g., CPC or CPB) preferred.

Physical Requirements:

Analytical mental capacity. Ability to perform computer data entry.