Medical Billing Manager

Medical Billing Manager 3.1 3.1 out of 5 stars 475 Northern Boulevard, Great Neck, NY 11021 $70,000

• $90,000 a year
• Full-time Compass Healthcare llc 11,363 reviews $70,000
• $90,000 a year
• Full-time Position Summary We are seeking an experienced and detail-oriented Medical Billing Manager to lead and oversee the full revenue cycle operations of our practice.

The ideal candidate will bring strong expertise in New York Medicaid and commercial insurance billing, hands-on experience managing claim denials and appeals, and proven leadership skills to manage billing staff and workflows. This role is responsible for ensuring clean claim submission, maximizing reimbursement, reducing denial rates, and maintaining compliance with all applicable regulations. Office Ally proficiency is required, and this is a fully on-site position. Key Responsibilities Oversee and manage the day-to-day operations of the billing department, including staff supervision, training, and performance management.

Lead the end-to-end revenue cycle:

charge entry, claim submission, payment posting, denial management, appeals, and A/R follow-up. Submit and manage claims through Office Ally, ensuring clean claim rates and timely resolution of rejections. Oversee billing for NY Medicaid (fee-for-service and managed care plans) and commercial insurance carriers, ensuring compliance with payer-specific requirements. Develop, implement, and refine billing policies, procedures, and internal controls to improve efficiency and reduce denials. Analyze denial trends, identify root causes, and lead corrective action plans across the team and with clinical/front-office staff. Review and approve appeals, corrected claims, and complex case escalations. Monitor aging A/R, key performance indicators (days in A/R, collection rate, denial rate, clean claim rate), and present regular reports to leadership. Verify that prior authorizations, eligibility checks, and referrals are properly handled across the team. Maintain advanced Excel-based dashboards, reconciliation reports, and tracking tools for management review. Ensure full compliance with HIPAA, CMS, and New York State Medicaid regulations. Serve as the primary liaison with payers, clearinghouses, and external auditors. Partner with providers and front-office staff to ensure documentation, coding, and authorizations support clean billing. Required Qualifications Minimum 5+ years of medical billing experience, with at least 2 years in a supervisory or management role. Demonstrated, hands-on experience billing New York Medicaid — including fee-for-service Medicaid and managed Medicaid plans (e.g., Healthfirst, Fidelis Care, MetroPlus, Empire BCBS HealthPlus, Affinity/Molina). Strong working knowledge of commercial insurance billing (Aetna, UnitedHealthcare, Cigna, BCBS/Empire, Oxford, GHI/Emblem, etc.), including fee schedules, contracts, and EOB interpretation. Proven track record managing claim denials, rejections, and appeals — including writing appeal letters, identifying denial trends, and implementing prevention strategies. Office Ally proficiency is a must — must be highly experienced with claim submission, claim status tracking, ERA management, and reporting within Office Ally. Solid understanding of

CPT, ICD-10, HCPCS

coding, and medical billing terminology. Advanced Excel skills are required — VLOOKUP/XLOOKUP, pivot tables, conditional formatting, filtering/sorting large datasets, and formulas for reconciliation and reporting. Familiarity with ePACES and eMedNY for NY Medicaid claim status, eligibility checks, and remittance retrieval. Experience with EHR / practice management systems (e.g., eClinicalWorks, AdvancedMD, Athena, Kareo, NextGen, or similar). Strong leadership, communication, and team management skills. Excellent analytical thinking, problem-solving, and organizational skills. Preferred Qualifications Knowledge of Availity (eligibility verification, claim status, remits, authorizations) is a strong plus. Certification such as Certified Professional Biller (CPB), Certified Medical Reimbursement Specialist (CMRS), or Certified Professional Coder (CPC). Bilingual (English/Spanish, Mandarin, or other) is a plus. Prior experience in behavioral health.

Pay:

$70,000.00

• $90,000.

00 per year

Work Location:

In person