How to Hire a Medical Billing Manager: Credentials, Sourcing and Screening

You are hiring someone to run the billing operation and the people in it, not a senior biller with a new title. On day one the seat has to supervise the staff who touch claims — charge entry, claim submission, payment posting, AR follow-up, denials, patient accounts — and know where every work queue stands without being handed a report.

O*NET's task list for medical and health services managers — the occupation group these managers sit in — includes directing, supervising and evaluating staff work, conducting fiscal operations including budgets and rates for services, and establishing work schedules and assignments according to workload. Ask each finalist for a concrete example of all three from their last seat.

The seat also owns the deadlines your claims live under. Medicare requires most claims to be filed no later than 1 calendar year after the date of service (42 CFR 424.44). A hire who has run billing can talk through how the filing clocks on your other payers work without opening a browser; one who cannot is learning your payers on your clock.

On education and experience, BLS says medical and health services managers typically need a bachelor's degree plus work experience in an administrative or clinical role in a health care facility, though some employers hire with an associate's degree and others prefer a master's. For a billing seat, the experience half of that sentence is the one to press on: years running or supervising a billing team in a setting like yours.

If you need the role itself defined — reporting lines, what the job covers in a practice versus a billing company — the career guide to what a medical billing manager does owns that question. This page stays on the hiring decision.

Certification is voluntary. BLS says employers may prefer to hire medical records specialists who have certification — the occupation group that holds the coders and records staff a billing manager supervises — or may expect applicants to earn certification shortly after being hired. For the manager seat itself, the useful question is not whether certification is legally required but which credential maps to the desk you are filling.

For a seat that runs billers, AAPC's CPB (Certified Professional Biller) is the billing-specific credential: AAPC describes it as validating expertise in the medical billing process — claim submission, payment posting, insurance guidelines and revenue cycle workflows.

Where the manager also carries practice-level duties, AAPC describes its CPPM (Certified Physician Practice Manager) as validating management of practice business operations including compliance, revenue cycle, HR, health information and governance. In a smaller practice where billing oversight is one of several hats, the CPPM maps to more of the desk than a billing-only credential would.

AAHAM describes its certification family as a career ladder beginning with the Certified Revenue Cycle Specialist (CRCS) and culminating with the Certified Revenue Cycle Executive (CRCE), with a professional-level exam for supervisors and managers — the supervisor-and-manager end is the end aimed at your seat. For hospital and health-system flavored seats, HFMA describes its CRCR as a national-level certification on the patient-centric revenue cycle, and says HFMA membership gives access to its certifications, most at no additional cost.

A defensible posting line puts experience first and letters second: "CPB, CPPM or equivalent billing-management experience." Verify whatever a candidate lists, at the issuing body. AAPC's online credential verification tool lets an employer check a member's AAPC credentials or status using the member ID and last name (or email and last name), returning the credential, earned date, renewal date and status. Read AAPC's terms before you build a spreadsheet of results: the tool is for verifying an individual's credentials only, compiling data or other commercial use is prohibited, and AAPC cannot guarantee absolute accuracy, so confirm the ID or email actually belongs to your candidate. Our research did not confirm a public online lookup for AAHAM's or HFMA's credentials; ask the body how to confirm a candidate's.

Credential rules and eligibility belong to the bodies that issue them. Confirm current CPB, CPPM, CRCS/CRCE and CRCR details with AAPC, AAHAM and HFMA before you write a requirement into your posting.

You have four realistic sources for this seat: your own staff, your referrals, your posting, and the billing offices of other organizations. Manager searches reward patience — you are hiring judgment built over years of running work queues, not a credential someone earned last spring.

Start inside. BLS says medical records specialists may advance to health information technologist or medical and health services manager roles after completing a higher certification program or earning a degree in health information technology. A strong billing supervisor or AR lead who finishes that kind of program already knows your payers, your systems and your staff.

Write the posting for the seat you actually have: setting and specialty, the systems you run, payer mix, team size, the credential line, and whether the seat is on-site, hybrid or remote.

Two hiring-law baselines apply to any ad. The EEOC says it is illegal to publish a job advertisement that shows a preference for, or discourages applicants because of, race, color, religion, sex (including pregnancy, sexual orientation and transgender status), national origin, age 40 or older, disability or genetic information.

Pay-disclosure duties also attach by state: California, Colorado, New York and Washington each require pay information in job postings under their own rules, and some write an employer-size threshold into the statute. Check your state labor agency's rule before you post.

Our guide to where to post billing and coding jobs compares the channels, and it pays to browse the medical billing manager jobs candidates already see on this board before you finalize the wording.

Referrals are worth working at this level. Your billing supervisors, AR staff and coders know which colleague actually kept a billing office clean, and a referred manager arrives with part of the reference check already done.

Budget time for the search, too. BLS projects employment of medical and health services managers — the occupation group that includes these managers — to grow 24.2% from 2025 to 2035, with about 62,300 openings per year on average. That is demand context for the whole occupation group, not a promise about your market, but it tells you an experienced candidate is interviewing you right back.

Screen in three passes — a structured interview, a scenario-based work sample and references — and score every candidate on the same sheet. OPM describes a structured interview as one in which all candidates get the same predetermined questions in the same order, with all responses rated on the same scale and standards, which it says helps candidates be assessed accurately and consistently.

Build the interview around the billing operation rather than generic leadership. Four prompts that work at manager level:

• You inherit our billing office on Monday — what do you review first, and what do you refuse to change until you understand it?
• A payer starts denying one of our highest-volume services — walk me through your first week of response.
• In your last role, who could write off a balance, adjust a charge or issue a refund, and how did you know it was being done right?
• A long-tenured biller's work queue keeps slipping — what do you do?

You are listening for sequencing, escalation judgment, and whether the candidate treats write-off and refund authority as a control question rather than a clerical one. The third prompt separates managers who have actually carried the seat from those who have only watched one.

The work sample settles the experience claim. Hand finalists a sanitized AR aging report, a remittance file or a payer policy excerpt, and ask for a short written read. Two federal requirements shape any test you give. The EEOC says a required test must be necessary and related to the job and may not exclude people based on protected characteristics. The ADA requires reasonable accommodation in test administration for qualified applicants with disabilities absent undue hardship.

References close the loop, and this seat carries authority over compliance-related decisions — the write-offs, adjustments and refunds above. OIG's 1998 compliance guidance for third-party billing companies says that for new employees with discretionary authority over compliance-related decisions, billing companies should conduct a reasonable and prudent background investigation including a reference check, and should require applicants to disclose criminal convictions or exclusion actions. A physician practice is not that guidance's subject, but a billing manager holds exactly the discretionary authority it describes, so the step travels well.

Two federal rules frame the background check itself. The EEOC says employers can consider criminal records in hiring decisions but cannot treat applicants with similar records differently because of race or national origin. And if the check runs through a consumer-reporting vendor, the FCRA applies: before you order the report, give the applicant a written, stand-alone notice — it cannot live inside the job application — and get written permission.

Before you reject anyone based on the report, the FCRA requires a pre-adverse-action notice with a copy of the report and the consumer-rights summary; the final adverse action notice — naming the reporting company and the person's dispute rights — comes after the decision. The FTC advises checking your state law first, because some states restrict employment use of these reports, usually credit reports.

The manager sits over claim submission and cash, so three rule sets attach at hire: federal exclusion screening, HIPAA workforce training, and the controls around the sign-off authority you just handed them.

Exclusion screening reaches this seat squarely. Per OIG, the federal payment ban on excluded people applies to anyone who employs or contracts with them and covers all administrative and management services they furnish — management work included. OIG states that anyone who hires an individual or entity on its List of Excluded Individuals/Entities (LEIE) may be subject to civil monetary penalties, and that health care entities should routinely check the list for new hires and current employees.

Check before the offer, then keep checking. OIG says entities should check the LEIE before employing or contracting with anyone and periodically afterward, and because OIG updates the list monthly, OIG says screening each month best minimizes potential overpayment and civil monetary penalty liability. OIG publishes the LEIE as an online searchable database, a downloadable CSV and monthly supplement files.

OIG's 2023 General Compliance Program Guidance — voluntary, nonbinding guidance, published November 2023 — lists monthly screening of the LEIE and state Medicaid exclusion lists among its examples of routine compliance monitoring, and notes that many state Medicaid programs keep their own exclusion lists.

One line in that guidance matters when you are staffing a small shop. OIG recommends that small entities that cannot support a compliance officer designate a compliance contact who, whenever possible, should not be involved in billing, coding or claim submission. Your billing manager is involved in billing by definition, so double-hatting the seat as your compliance contact blends two roles OIG suggests separating where the organization can — a staffing question to take to your compliance contact or health-care counsel.

The compliance point that trips employers up is not exotic: it is the sign-off authority you hand the seat. A billing manager who approves write-offs, adjustments and refunds holds exactly the discretionary authority over compliance-related decisions that OIG's billing-company guidance ties background checks and disclosure requirements to. Pair that authority with controls you can see: written thresholds for who may write off what, a second set of eyes above a line you set, and a monthly review of the adjustments file. That is an internal-control design question to settle with your CPA or health-care counsel, not a formula this page can hand you.

Put the overpayment clock on the manager's dashboard too. Under the federal rule, a Medicare overpayment must be reported and returned by the later of 60 days after it is identified or the date a cost report is due. The deadline can be suspended for up to 180 days while a timely good-faith investigation of related overpayments is under way. Whoever approves adjustments needs to know that clock exists.

HIPAA training runs through the seat as well. The Privacy Rule requires a covered entity to train all members of its workforce on its PHI policies and procedures as necessary and appropriate for their functions. New workforce members must be trained within a reasonable period after joining; the rule sets no fixed annual frequency, and training must be documented. The Security Rule adds a security awareness and training program for all workforce members including management. The annual rhythm comes from OIG's 2023 compliance guidance, which recommends compliance-program training at least annually for board members, officers, employees, contractors and medical staff, guided by an annual training plan.

Our guide to screening hires against the OIG exclusion list walks the mechanics step by step.

Same billing operation, three delivery models, and the manager seat changes shape in each. Choose on claim volume, team size and how much oversight you can personally carry, not on principle.

In-house keeps the seat next to your billers, posters and front desk, which keeps escalations inside the building. Remote widens the candidate pool past your zip code and moves PHI into a home workspace. The Security Rule's physical safeguards — policies on workstation use and physical safeguards for all workstations that access ePHI — reach home workstations used by remote staff. Settle equipment, workspace and access expectations in the offer letter, not in the first week of training.

One classification trap hides in the remote option. The IRS says a remote worker is a common-law employee if the business can control what will be done and how, even if the worker chooses to work remotely, and its common-law test weighs behavioral control, financial control and the type of relationship. A billing manager you direct daily is your employee no matter whose laptop they use, so confirm classification with a CPA before anyone invoices you as a contractor.

Pay structure has its own baseline. The FLSA white-collar exemption salary level is $684 per week ($35,568 a year) as of the DOL's May 15, 2026 restoration of the prior regulations. Salary alone does not make a biller or coder exempt — the administrative exemption also requires a primary duty of office work directly related to management or general business operations and the exercise of discretion and independent judgment on matters of significance. Confirm the classification of the seat you design with the DOL's rules or a CPA rather than assuming the title settles it.

Outsourcing replaces the hire with a vendor and a contract, and the contract questions arrive before the first claim moves. Billing and claims processing are among HHS's examples of activities that make a vendor a HIPAA business associate when PHI is involved. The business associate agreement must carry the elements the rule lists, among them permitted uses and disclosures, safeguards, breach reporting, subcontractor flow-down, and return or destruction of PHI at termination when feasible.

If a vendor would receive and negotiate your Medicare payments in your name, Medicare's billing-agent conditions apply. Among them: the agent's compensation may not be related in any way to the dollar amounts billed or collected, and may not be dependent on actual collection. CMS's Claims Processing Manual says those compensation conditions do not apply when the agent merely prepares bills and does not receive and negotiate the provider's checks — and OIG has a longstanding concern that percentage-based billing arrangements may increase the risk of upcoding. Read any proposed fee structure against those rules with your MAC and health-care counsel before you sign.

Whichever model you pick, the seat sits inside a department. Our guide to hiring billing and coding staff works through the role mix, the outsourcing decision and the rest of the team around this one.

Retention for this seat runs on three levers: pay benchmarked honestly, credentials you sponsor, and authority that matches the accountability you hired.

On pay, use the labeled federal numbers as a bracket, not a target. BLS OEWS May 2025 puts medical and health services managers (SOC 11-9111, all industries — the closest available group) at a median of $123,860 a year, with the middle half earning $94,700 to $166,100. BLS does not separate billing managers within the code, and the group covers all health care managers, hospital executives included, so it runs above typical billing-manager pay. Price against your market, your payer mix and the size of the team the seat actually runs.

Training is a cheaper lever than a counteroffer. OIG's 2000 physician-practice guidance recommends at least an annual coding and billing training program for everyone involved in coding and billing. It also says new coding and billing staff should be trained as soon as possible and work under an experienced employee until training is complete. A manager who does not have to invent that structure on arrival will notice. Sponsoring the credentials from the screening section gives the seat a visible next rung, too.

Give the seat the authority you hired it for. The schedule-setting, staff-evaluation and fiscal responsibilities in the occupation group's task list belong to your manager, not to whoever talks to you last each week. A manager who owns a decision can be paid for owning it; one who has to escalate every write-off is doing two jobs and will eventually take the combined title somewhere else.

Track your own vacancies, your own refill times and your own billing metrics after every departure: your numbers, not a published benchmark, are the retention plan that works.

Employer information, not coding, billing-compliance, legal or tax advice. The rules named here belong to their agencies — the OIG, HHS OCR, CMS, the FTC, the EEOC, the DOL and the IRS — and they change. Confirm exclusion screening, background checks, applicant testing, worker classification and HIPAA training with the agency named, and with a CPA or health-care counsel where pay, classification and contracts are involved.