Manager - Biller/Coder
Senior Medical Billing & Coding / RCM Leader Location: United States Work Mode: Remote Experience: 15–20 Years Industry: US Healthcare / Revenue Cycle Management (RCM) Travel: Up to 50% within the US and/or internationally, as required Position Overview We are seeking a highly experienced Senior Medical Billing & Coding / RCM Leader with 15–20 years of strong experience in the US Healthcare Revenue Cycle Management (RCM) industry. The ideal candidate should have extensive experience working with an RCM Organization, managing end-to-end medical billing and coding operations and leading remote, geographically distributed medical billing/coding teams supporting multiple healthcare providers accounts across multiple locations. This role requires a hands-on leader with strong knowledge of the US healthcare revenue cycle, payer processes, medical billing and coding, denial management, AR, collections, compliance, and operational performance. The candidate will be responsible for ensuring high-quality RCM delivery, improving revenue performance, managing remote teams, strengthening client relationships, and driving operational excellence.
Key Responsibilities
RCM & Billing Operations Oversee end-to-end US healthcare Revenue Cycle Management (RCM) operations. Provide strategic and operational leadership across medical billing, coding, charge entry, claims submission, payment posting, AR follow-up, denials and collections. Ensure accurate and timely claim submission and effective resolution of claim rejections and denials. Monitor AR aging, outstanding claims, reimbursement trends and collection performance. Identify revenue leakage and implement corrective actions to improve collections and cash flow. Ensure adherence to payer-specific billing requirements, timely filing limits and reimbursement guidelines. 2. Medical Billing & Coding Oversight Provide expert oversight of ICD-10-CM, CPT, HCPCS, modifiers, E/M coding and documentation requirements. Ensure coding and billing accuracy and minimize claim errors and compliance risks. Establish quality-control and audit mechanisms for billing and coding operations. Review coding/billing trends and implement process improvements. Work closely with coding, billing, clinical and client teams to resolve complex billing and coding issues. 3. Remote & Multi-Location Team Management Lead and manage remote medical billing and coding teams working across multiple geographic locations. Experience managing distributed teams supporting multiple US healthcare clients/providers is highly desirable. Establish clear productivity, quality, SLA and turnaround-time expectations. Monitor team performance through defined KPIs and operational dashboards. Conduct regular performance reviews, coaching and capability-building initiatives. Ensure effective communication and coordination across different locations, shifts and functions. Build a culture of accountability, quality, ownership and continuous improvement. 4. Client & Stakeholder Management Act as a senior point of contact for US-based healthcare clients and stakeholders. Participate in client meetings, operational reviews and business discussions. Understand client-specific workflows, payer mix, specialties and RCM requirements. Address escalations and develop timely corrective and preventive action plans. Prepare and present operational performance reports, trends and improvement plans to senior leadership and clients. 5. Performance & KPI Management Develop, monitor and improve key RCM performance indicators, including: Clean Claim Rate First Pass Resolution Rate Days in A/R A/R Aging Denial Rate Net Collection Rate Gross Collection Rate Payment Posting Accuracy Coding Accuracy Claim Turnaround Time Productivity and Quality Scores Client SLA Compliance 6. Process Improvement & Technology Identify opportunities to improve RCM workflows, productivity and revenue realization. Drive standardization and automation of billing and coding processes. Evaluate and optimize the use of EHR, EMR, Practice Management and RCM platforms. Support implementation of new workflows, technologies and process improvements. Analyze operational data to identify trends, bottlenecks and opportunities for improvement. 7. Compliance & Quality Ensure strict adherence to HIPAA and applicable US healthcare billing and coding regulations. Maintain confidentiality and security of patient information. Ensure billing and coding activities comply with payer and regulatory requirements. Conduct periodic quality and compliance audits. Keep the team updated on relevant changes in coding, billing and payer requirements. Required Qualifications 15–20 years of experience in US Healthcare RCM, medical billing and/or medical coding. Mandatory experience working with an RCM/BPO/Healthcare Services company. Proven experience managing large, remote and geographically distributed medical billing/coding teams. Strong understanding of the complete US healthcare revenue cycle. Extensive experience with: Medical Billing Medical Coding Claims Processing AR Management Denial Management Payment Posting Insurance Follow-up Appeals & Reconsiderations Collections Charge Entry Eligibility & Authorization Strong knowledge of ICD-10-CM, CPT, HCPCS and medical billing guidelines. Experience working with multiple healthcare specialties and payer types. Strong knowledge of Medicare, Medicaid and Commercial payers. Demonstrated experience managing client-facing operations in an RCM environment. Strong analytical, problem-solving and decision-making skills. Excellent written and verbal communication skills. Strong leadership and people-management capabilities. Proficiency with MS Excel, reporting tools and healthcare/RCM systems.
Preferred Qualifications
CPC, CCS, CPB, CPMA or equivalent certification preferred. Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field preferred. Experience handling multi-specialty RCM operations. Experience managing teams across different time zones and locations. Experience with RCM/EHR/EMR platforms and healthcare technology solutions. Proven track record of improving collections, reducing denials and optimizing operational performance. Please share your CV at [email protected]