LaJoy Group

Compensation

Full Description

Salary: Job Title: Billings/Claims Manager FLSA Status: Exempt Schedule: Monday through Friday, 8:00am to 5:00pm with occasional work after hours Type: Hybrid (2-3 days in office, 2-3 days remote) Location: Livonia, MIwith occasional travel to Bay City or Sterling Heights ________________________________________ Position Summary: The Billings/Claims Manager is responsible for overseeing all billing and claims operations, ensuring accurate and timely submission, auditing, and reconciliation records. This role includes direct supervision and leadership of the billing team to ensure departmental goals are met and compliance standards are maintained. The ideal candidate has strong managerial capabilities, attention to detail, and a deep understanding of billing, claims processing, and payer requirements. ________________________________________ Key Responsibilities: Billing & Claims Operations Process claims and document. Oversee accurate and timely data entry and submission of all claims to appropriate payers. Manage the full claims lifecycle including submissions, rejections, denials, and resubmissions. Ensure billing procedures comply with payer policies, regulatory standards, and organizational guidelines. Identify, research, and resolve billing discrepancies and rejected or denied claims. Staff Management & Leadership Directly supervise billing staff including assigning tasks, setting priorities, and monitoring productivity. Hire, train, and evaluate billing team members to ensure consistent performance and development. Provide ongoing coaching, feedback, and support to the billing team. Schedule and lead regular team meetings to communicate updates, address issues, and reinforce best practices. Ensure adequate staffing levels and manage time-off requests to maintain workflow continuity. Auditing & Quality Assurance Conduct regular audits of billing and claims to verify accuracy, completeness, and compliance. Monitor billing staff performance through audit results and provide corrective action when needed. Implement quality control procedures to reduce claim rejections and denials. Reconciliation & Reporting Reconcile daily, weekly, and monthly billing totals with payments received. Analyze billing data to identify trends, gaps, or inefficiencies, and recommend process improvements. Prepare and present regular reports on billing performance and staff productivity. Cross-Functional Collaboration Work with billers, management and coordinators to resolve claim issues and improve billing accuracy. Serve as the primary point of contact for complex billing inquiries. Qualifications Education & Experience Bachelors degree in Healthcare Administration, Business, Finance, or a related field (required). 35 years of progressive experience in billing and claims management, with at least 2 years in a supervisory role. Experience in healthcare billing (medical, dental, behavioral health, etc.) strongly preferred. Relevant certifications (e.g., CPB, CMRS, CPC, or CCA) are a plus. Skills & Competencies Proven leadership and team management skills. Strong knowledge of billing practices, claim submission processes, and payer requirements. Proficient in Microsoft Excel. Excellent analytical, organizational, and problem-solving skills. Clear and effective verbal and written communication abilities. ________________________________________ What We Offer! Competitive salary and benefits package Health, dental, and vision insurance Immediate eligibility to the 401K plan Paid time off and holidays Professional development opportunities Supportive and inclusive work environment This job requires a criminal background check. Convictions and pending felony charges are not an absolute bar to employment and will only be considered if required by law or there is a substantial relationship to the circumstances of the particular job or if bond ability is at issue. LaJoy Group is an Equal Employment Opportunity. #INDINTERNAL