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Billing Operations Manager Personal Injury & Workers Compensation

Billing Operations Manager Personal Injury & Workers Compensation

MedullaOak Brook, IL, US
14 days ago
Job type
  • Full-time
Job description

Billing Operations Manager Personal Injury & Workers' Compensation

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.

    • 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.

    • Preferred 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
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    Personal Injury • Oak Brook, IL, US

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