RCM PIP Insurance Billing Manager

Job Description ClinicMind's core valuesExcellence - Learning - Teamwork guide everything we build. With150 inhouse analysts, half a dozen BPO partners, and a proprietary billing platform, we now need a manager to deliver bestinclass collections, continue to improve performance, automate, and meet the RCM needs of a rapidly growing client base. Position Summary The PIP Insurance Billing Manager oversees and manages all aspects of the Personal Injury Protection (PIP) billing process. This position is responsible for ensuring timely and accurate submission of PIP claims, managing a team of PIP billers and follow-up specialists, and ensuring compliance with all state-specific insurance laws, payer requirements, and internal policies. The manager works closely with attorneys, patients, providers, and insurance adjusters to resolve claim issues and maximize reimbursement. Key Responsibilities - Leadership & Oversight: - Supervise, train, and mentor a team of PIP billers and collection specialists. - Assign and monitor daily workloads to ensure timely and accurate billing and follow-up on all PIP claims. - Conduct regular performance evaluations, provide coaching, and implement process improvements to enhance team productivity. - Foster a positive and collaborative work environment. - Billing & Claims Management: - Oversee the preparation and submission of all PIP claims, ensuring accuracy and compliance with state-specific requirements. - Review and approve adjustments, write-offs, and appeals to ensure they align with company policies and payer guidelines. - Monitor claim status reports and follow up on unpaid, underpaid, or denied PIP claims. - Ensure proper coding (ICD, CPT, HCPCS) and documentation for all submitted claims. - Compliance & Quality Assurance: - Stay current with state PIP laws, no-fault insurance requirements, and payer policies. - Ensure that all billing practices are compliant with federal, state, and payer-specific regulations. - Develop and implement standard operating procedures (SOPs) for PIP billing and collections. - Conduct periodic internal audits to identify and correct billing errors or compliance risks. - Reporting & Analysis: - Generate and analyze billing, collections, and aging reports for PIP accounts. - Track performance metrics including days in A/R, denial rates, and reimbursement trends. - Provide regular updates and strategic recommendations to leadership regarding PIP collections performance. - Collaboration & Communication: - Serve as the primary liaison between billing staff, clinical teams, attorneys, and insurance carriers. - Work with providers and medical records departments to ensure timely receipt of necessary documentation. Qualifications - Education: - Associate's or Bachelor's degree in Business Administration, Healthcare Management, or related field preferred. - Equivalent combination of education and experience may be considered. - Experience: - Minimum 3-5 years of experience in PIP billing or no-fault insurance claims required. - Strong understanding of state-specific PIP and no-fault laws. - Skills & Competencies: - Deep knowledge of insurance billing, reimbursement processes, and medical terminology. - Excellent leadership, communication, and problem-solving skills. - Strong analytical and organizational abilities with attention to detail. - Proficiency in Microsoft Office Suite (Excel, Word, Outlook). - Ability to work under pressure, meet deadlines, and manage competing priorities. Performance Indicators - Accuracy and timeliness of PIP claim submissions. - Reduction in claim denials and days in accounts receivable. - Team productivity and morale. - Compliance audit results. - Overall recovery rate of PIP reimbursements. Must Have - High comfort level working on Eastern Time Zone/US Shift - Good internet access at home - Mobile Hotspot - Laptop/Desktop with at least 16 GB