Medical Billing Manager

Optima Medical is an Arizona-based medical group consisting of 30 locations and over 130+ medical providers, who care for more than 200,000 patients statewide. Our mission is to improve the quality of life throughout Arizona by helping communities "Live Better, Live Longer" through personalized healthcare, with a focus on preventing the nation’s top leading causes of death. We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services. We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard. The ideal candidate will have experience in a fast-paced healthcare or billing environment, with strong attention to detail and a passion for resolving claims efficiently to ensure a positive patient and provider experience.

Position Summary: 

• Manage and oversee the day-to-day operations across multiple departments
• Collaborate with department leads to improve workflow, productivity, and claim accuracy
• Identify trends in provider charges, denials, and potential underpayments 
• Oversee the daily operations of the charge entry team, ensuring all charges are coded, reconciled, and submitted timely
• Perform and assist with claim edits ie; documentation review, ICD to CPT mapping, CPT crosswalks, providing feedback to improve claim scrubbing edits
• Ensure compliance with payer rules and internal policies
• Organize, develop, and maintain revenue cycle SOPs
• Identify, research, and resolve claim issues as needed through direct contact with payors 
• Communicate with clinic managers to resolve medical billing delays / issues
• Incomplete progress notes, coding discrepancies, eligibility issues, patient balance inquiries 

• Monitor weekly RCM reports from department managers and 
• Utilize reporting and analytics (Microsoft Excel-based) to provide feedback, track performance, and recommend improvements

• Minimum of 5 years experience in medical billing & coding for primary care specialty group
• Minimum of 3 years experience in a leadership role
• Intermediate/Advanced proficiency with Microsoft Excel (reporting, tracking, analysis)
• Strong problem-solving and communication skills
• Experience with eClinical preferred