ZipRecruiter
Billing Operations Manager - Personal Injury & Workers' Compensation
ZipRecruiter, Oak Brook, Illinois, United States, 60523
Overview
The PI/WC Billing Manager is responsible for leading and overseeing the operations of the Personal Injury and Workers’ Compensation function. This role focuses on managing a team of coordinators, optimizing workflows, ensuring compliance with legal and ethical standards, driving performance outcomes, ensuring that departmental goals align with organizational objectives and that all PI/WC cases are handled efficiently and professionally. Key Responsibilities
Team Leadership & Oversight
Supervise and support a team of PI/WC coordinators, ensuring clarity of roles, accountability, and high performance. Provide coaching, training, and development opportunities to team members to enhance skills and knowledge. Monitor team productivity and quality metrics and implement performance improvement plans as needed. Foster a collaborative, professional, and positive team culture.
Workflow & Process Management
Design, implement, and continuously improve workflows for PI/WC case management, billing, and documentation. Ensure timely verification, submission, and follow-up of claims through effective delegation and oversight. Establish and maintain standardized procedures to ensure consistency, accuracy, and compliance across all cases. Coordinate cross-functional collaboration with billing, clinical, and legal teams to streamline operations.
Compliance & Quality Assurance
Ensure all PI/WC processes comply with HIPAA, state lien laws, and personal injury statutes. Conduct regular audits of open and closed cases to ensure documentation accuracy and ethical billing practices. Stay current on regulatory changes and industry best practices and update departmental protocols accordingly.
Stakeholder Communication
Serve as the primary escalation point for complex or high-risk cases involving insurance companies, attorneys, or providers. Maintain strong relationships with internal and external stakeholders to facilitate case resolution and settlement negotiations. Provide regular updates to leadership on departmental performance, challenges, and opportunities for improvement.
Technology & Reporting
Oversee the effective use of EHR systems and departmental software to track case progress and performance metrics. Ensure accurate and timely reporting of departmental KPIs, including case turnaround times, settlement rates, and outstanding balances. Leverage data to identify trends, forecast needs, and support strategic decision-making.
Qualifications
Minimum Qualifications 5+ years of experience in healthcare billing, with a focus on personal injury and workers’ compensation. Strong understanding of insurance guidelines, lien laws, and HIPAA compliance. Proven experience managing or leading a team in a healthcare or revenue cycle environment Qualifications 2+ years of supervisory experience in a healthcare or legal billing setting. Familiarity with EHR systems and case management software. Job Competencies Strategic thinking and process optimization Team leadership and staff development Strong communication and interpersonal skills Analytical mindset with attention to detail Ability to manage competing priorities in a fast-paced environment Professionalism and composure in high-stakes situations Additional Information
#ZR Disclaimer All team members agree to consistently support compliance and TVG-Medulla, LLC policies and Standards of Excellence with regard to maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, adhering to applicable federal, state, and local laws and regulations, accreditation, and licenser requirements (if applicable), and Medulla procedures and protocols. Must perform other related duties and assist with project completion as needed. Team member may be required to provide necessary information to complete a DMV (or equivalent agency) background check.
#J-18808-Ljbffr
The PI/WC Billing Manager is responsible for leading and overseeing the operations of the Personal Injury and Workers’ Compensation function. This role focuses on managing a team of coordinators, optimizing workflows, ensuring compliance with legal and ethical standards, driving performance outcomes, ensuring that departmental goals align with organizational objectives and that all PI/WC cases are handled efficiently and professionally. Key Responsibilities
Team Leadership & Oversight
Supervise and support a team of PI/WC coordinators, ensuring clarity of roles, accountability, and high performance. Provide coaching, training, and development opportunities to team members to enhance skills and knowledge. Monitor team productivity and quality metrics and implement performance improvement plans as needed. Foster a collaborative, professional, and positive team culture.
Workflow & Process Management
Design, implement, and continuously improve workflows for PI/WC case management, billing, and documentation. Ensure timely verification, submission, and follow-up of claims through effective delegation and oversight. Establish and maintain standardized procedures to ensure consistency, accuracy, and compliance across all cases. Coordinate cross-functional collaboration with billing, clinical, and legal teams to streamline operations.
Compliance & Quality Assurance
Ensure all PI/WC processes comply with HIPAA, state lien laws, and personal injury statutes. Conduct regular audits of open and closed cases to ensure documentation accuracy and ethical billing practices. Stay current on regulatory changes and industry best practices and update departmental protocols accordingly.
Stakeholder Communication
Serve as the primary escalation point for complex or high-risk cases involving insurance companies, attorneys, or providers. Maintain strong relationships with internal and external stakeholders to facilitate case resolution and settlement negotiations. Provide regular updates to leadership on departmental performance, challenges, and opportunities for improvement.
Technology & Reporting
Oversee the effective use of EHR systems and departmental software to track case progress and performance metrics. Ensure accurate and timely reporting of departmental KPIs, including case turnaround times, settlement rates, and outstanding balances. Leverage data to identify trends, forecast needs, and support strategic decision-making.
Qualifications
Minimum Qualifications 5+ years of experience in healthcare billing, with a focus on personal injury and workers’ compensation. Strong understanding of insurance guidelines, lien laws, and HIPAA compliance. Proven experience managing or leading a team in a healthcare or revenue cycle environment Qualifications 2+ years of supervisory experience in a healthcare or legal billing setting. Familiarity with EHR systems and case management software. Job Competencies Strategic thinking and process optimization Team leadership and staff development Strong communication and interpersonal skills Analytical mindset with attention to detail Ability to manage competing priorities in a fast-paced environment Professionalism and composure in high-stakes situations Additional Information
#ZR Disclaimer All team members agree to consistently support compliance and TVG-Medulla, LLC policies and Standards of Excellence with regard to maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, adhering to applicable federal, state, and local laws and regulations, accreditation, and licenser requirements (if applicable), and Medulla procedures and protocols. Must perform other related duties and assist with project completion as needed. Team member may be required to provide necessary information to complete a DMV (or equivalent agency) background check.
#J-18808-Ljbffr