Hospital Billing Manager (Government): Business Service-Managed Care

The Manager of Hospital Billing is responsible for the overall operations and management of Patient Financial Services. This position oversees billing, collections, cash management, regulatory compliance and participation in long-term strategy for Patient Financial Services. Oversees department supervisors and billing staff and is responsible for performance management of employees. Identifies and coordinates training of all patient accounting and managed care staff. Works with staff to focus specifically on collections of Medicare, Work Compensation, group insurance, and private pay accounts.  Serves as a point of escalation for complaints and issues. Uses monthly statistical reports to identify progress and trends with credit balances, aged accounts, and overall status of accounts. Standardizes and streamlines processes for efficiencies to improve revenues. Supports the business office and hospital mission. Performs other duties as assigned.

Additional Responsibilities

Leadership and Management:

·         Supervise and mentor a team of billing specialists.

·         Conduct regular performance evaluations and provide training as needed.

·         Develop and implement policies and procedures to improve billing efficiency and accuracy.

Billing Operations:

·         Oversee the preparation and submission of Medicare, Medi-Cal, other government and patient claims.

·         Ensure all claims are compliant with Medicare and government regulations and guidelines.

·         Monitor and resolve billing discrepancies and denials.

Compliance and Reporting:

·         Stay updated on changes in Medicare billing regulations and ensure the team is informed.

·         Prepare and present regular reports on billing activities, collections, and outstanding claims.

·         Conduct internal audits to ensure compliance and identify areas for improvement.

·         Supports Accounting Department with supplying information related to Medicare Cost Reporting

Patient Interaction:

·         Address patient inquiries and concerns regarding billing.

·         Provide clear and accurate information to patients about their billing statements and payment options.

·         Work with patients to resolve billing issues and facilitate payment plans if necessary.

Collaboration:

·         Work closely with the finance department to reconcile accounts and ensure accurate financial reporting.

·         Collaborate with clinical staff to ensure accurate documentation and coding of services.

·         Liaise with Medicare representatives to resolve complex billing issues.

Qualifications

Education and Experience

Bachelor’s degree or Master’s degree in Business or Hospital Administration or related field or equivalent years of service within scope of Revenue Cycle required. Experience with California collection law and insurance billing regulations required. Experience in Patient Financial Services. Experience with revenue cycle management in a hospital setting.

·         Minimum of 5 years of experience in hospital billing, with at least 2 years in a supervisory role.

·         Experience with California collection law and insurance billing regulations required. 

·         Experience in Patient Financial Services.

·         In-depth knowledge of Medicare billing regulations and guidelines.

·         Strong leadership and team management skills.

·         Excellent analytical and problem-solving abilities.

·         Proficiency in billing software and electronic health records (EHR) systems, EPIC preferred.

·         Strong communication and interpersonal skills.

Preferred Qualifications:

·         Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS) certification.

·         Call Center Experience

Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.

Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.

Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.

To learn more about Hoag’s awards and accreditations, visit: https://www.hoag.org/about-hoag/awards-accreditations/.

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.