Medical Billing and Collections Manager - Tandym

Job Title: Medical Billing and Collections Manager
Location: Paterson, NJ
Hours: M-F Business Hours; Onsite Position

We are seeking a Medical Billing and Collections Manager to oversee the timely and accurate management of surgical claims. This role requires strong leadership skills and a deep understanding of claims adjudication, insurance policies, CMS guidelines, and coding. The Manager will lead a team of billers and collectors, ensuring claim resolution, denial management, and compliance with regulations.

Responsibilities:

* Supervise and manage a team of billers and collectors.
* Oversee the processing and follow-up of surgical claims and aging reports.
* Lead communication with insurance companies to resolve denials and claims issues.
* Develop strategies to reduce denials and improve collection performance.
* Ensure timely submission and processing of claims to primary and secondary payors.
* Guide team members in writing appeals and resolving complex claims.
* Track and manage team performance against established goals.
* Ensure adherence to policies, procedures, and regulatory guidelines.

Requirements:

* High School Diploma or GED required.
* Minimum of 5 years of experience in Medical Billing and Collections, with at least 3 years in a leadership role.
* Coding experience required.
* CPC certification preferred.
* Experience with Navinet, Optum, Availity, and EMR systems (eClinicalWorks).
* Strong organizational, communication, and problem-solving skills.

Skills/Abilities:

* In-depth knowledge of Medicare billing and insurance guidelines.
* Proficient in Outlook, Word, and Excel.
* Ability to lead a team and drive performance.