Manager, Payer Clinical Services (HBA)

📋 Description

• Oversee hospital bill audits, including outpatient and facility reviews, ensuring accuracy
• Apply relevant coding guidelines, payer policies, and clinical references to support high-quality
• Identify quality gaps, operational challenges, and improvement opportunities, translating findings
• Build and maintain strong client relationships by understanding client needs, addressing concerns
• Analyze denial trends and other client data, communicate findings to clinical and coding teams, and
• Lead onboarding and ongoing training for clinical staff on technology, regulatory changes, coding

🎯 Requirements

• Active coding certification such as CCS, CPC, or CIC is required.
• Registered Nurse credentials are preferred.
• Extensive experience overseeing hospital bill audits, itemized bill reviews, and high-dollar
• Previous experience leading or managing teams, with a demonstrated ability to coach employees
• Experience developing and delivering training for new and existing team members.
• Strong knowledge of CPT, HCPCS, ICD-10, revenue codes, CMS requirements, and industry-standard

🎁 Benefits

• Annual salary range of $90,000–$120,000
• Comprehensive compensation package designed to support employee well-being and professional growth.
• Health insurance coverage.
• 401(k) retirement plan with employer matching.
• Paid parental leave.
• Collaborative and innovative work environment.