Benefits:
401(k) matching
Bonus based on performance
Company parties
Dental insurance
Employee discounts
Health insurance
Paid time off
Vision insurance
Position Overview:
The Medical Billing Manager at Skin Wellness Physicians (SWP) oversees all financial and billing operations across our multi-location dermatology practice. This role is responsible for ensuring efficient and compliant revenue cycle management, accurate financial reporting, and the optimization of billing processes within the Modernizing Medicine (ModMed) platform. The Medical Billing Manager will work closely with the COO, Clinical/Front Office Operations Managers, and Billing team to safeguard financial performance, streamline workflows, and support strategic growth initiatives, including the expansion of our medical dermatology and pathology divisions.
Key Responsibilities:
Revenue Cycle Management
Supervise all billing department operations including charge entry, claims submission, payment posting, adjustments, and patient billing.
Oversee reconciliation between ModMed EMR and clearinghouse submissions to ensure accurate and timely claims processing.
Monitor and manage Accounts Receivable aging, identify trends, and drive strategies to reduce outstanding balances.
Review insurance denials, underpayments, and rejections; implement corrective actions to maximize reimbursement.
Collaborate with providers to ensure clinical documentation accurately supports billed CPT/ICD-10 codes and modifier usage.
Ensure all processes comply with HIPAA, CMS, and payer regulations.
Financial Reporting & Analytics
Prepare monthly financial summaries including AR aging, collections, payer mix, and provider productivity metrics.
Analyze trends and variances against budgets and prior periods to support administrative decision-making.
Work with the COO to develop and maintain budget forecasts, financial dashboards, and performance reports.
Oversee daily reconciliation of deposits, EFTs, and merchant transactions; ensure synchronization with EMR and bank statements.
Support reporting for medical dermatology, Pathology Lab, and other new service lines.
Compliance & Audit Readiness
Maintain readiness for payer, CMS, and internal audits by ensuring proper documentation and coding accuracy.
Implement internal controls to safeguard against billing errors and potential compliance risks.
Conduct periodic audits of high-volume or high-risk procedure codes to ensure proper capture and reimbursement.
Leadership & Staff Management
Directly supervise billing and posting staff, including daily task assignment, workflow oversight, and accountability for performance metrics.
Establish and monitor clear KPIs for individual and team productivity (e.g., claim turnaround time, payment posting accuracy, AR follow-up rates).
Conduct formal staff performance reviews at regular intervals, providing constructive feedback, goal setting, and career development guidance.
Identify training needs and create ongoing education plans to enhance billing accuracy, payer knowledge, and compliance.
Develop, implement, and maintain Standard Operating Procedures (SOPs) for all billing and posting workflows to ensure consistency across locations.
Hold regular billing team meetings to review metrics, discuss payer updates, and reinforce best practices.
Address performance or behavioral issues promptly; initiate Performance Improvement Plans (PIPs) when appropriate.
Promote a culture of professionalism, collaboration, and accountability between billing, front office, and clinical departments.
Work with the COO to align staffing levels and roles with growth, provider onboarding, and overall practice expansion.
Support cross-training within the department to ensure coverage during absences and uninterrupted billing operations.
Collaboration & Strategic Support
Work directly with the COO, CFO, CPA and external accounting partners to prepare quarterly and annual financial reports.
Assist in evaluating ROI for new services, equipment, and provider additions.
Contribute to operational improvement initiatives, including automation, workflow redesign, and efficiency tracking.
Qualifications:
Education in accounting, Finance, Healthcare Administration, or related field a plus.
Minimum 5–7 years of progressive experience in medical billing, AR management, and healthcare finance—dermatology or specialty practice experience preferred.
In-depth understanding of CPT, ICD-10, modifiers, and payer reimbursement models.
Hands-on experience with Modernizing Medicine (ModMed) a plus.
Proficiency with Excel (pivot tables, dashboards), and financial reconciliation.
Strong leadership, analytical, and communication skills.
Proven ability to manage multiple priorities and meet deadlines in a fast-paced, high volume, multi-location environment.
Core Competencies:
Accuracy and Accountability in Financial Oversight
Strategic and Analytical Thinking
Leadership and Staff Mentoring
Compliance and Ethical Integrity
Cross Departmental Collaboration