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Medicare Operations Manager Jobs in Virginia (NOW HIRING)

WCRC Attorney (59175)

Arlington, VA ยท On-site

$75 - $85/hr

Implement Medicare policy. Other duties as assigned by management.**Qualifications:*** Juris Doctor ... operations.**Reasonable Accommodation:**If you require alternative methods of application or ...

Technical Program Manager - HHS

Reston, VA ยท On-site

$134K - $173K/yr

... Medicare & Medicaid Services (CMS), National Institutes of Health (NIH), or Centers for Disease ... Translate agency mission and operational requirements into actionable technical strategies and ...

Technical Program Manager - HHS

Reston, VA ยท On-site

$134K - $173K/yr

... Medicare & Medicaid Services (CMS), National Institutes of Health (NIH), or Centers for Disease ... Translate agency mission and operational requirements into actionable technical strategies and ...

Key Responsibilities 1. Clinical Leadership & Operations * Oversee daily clinic workflow, including ... Knowledge Strong understanding of Medicare/Insurance billing and HIPAA compliance. Soft Skills ...

Technical Program Manager - HHS

Reston, VA ยท On-site

$134K - $173K/yr

... Medicare & Medicaid Services (CMS), National Institutes of Health (NIH), or Centers for Disease ... Translate agency mission and operational requirements into actionable technical strategies and ...

Technical Program Manager - HHS

Reston, VA ยท On-site

$134K - $173K/yr

... Medicare & Medicaid Services (CMS), National Institutes of Health (NIH), or Centers for Disease ... Translate agency mission and operational requirements into actionable technical strategies and ...

Showing results 41-60

Medicare Operations Manager information

See Virginia salary details

$30.7K

$62.9K

$117.5K

How much do medicare operations manager jobs pay per year?

As of Sep 6, 2026, the average yearly pay for medicare operations manager in Virginia is $62,912.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,600.00 and $76,800.00 per year, depending on experience, location, and employer.

What is a Medicare Operations Manager?

Medicare Operations Managers are professionals responsible for overseeing the daily operations of Medicare-related services within healthcare organizations or insurance companies. They ensure compliance with federal regulations, manage teams that process Medicare claims, and work to optimize workflows and efficiency. Their role also involves monitoring performance, implementing policy changes, and coordinating with other departments to ensure high-quality service for Medicare beneficiaries. These managers play a critical role in maintaining regulatory standards and improving overall operational effectiveness.

What are the key skills and qualifications needed to thrive as a Medicare Operations Manager?

To thrive as a Medicare Operations Manager, you need expertise in healthcare administration, Medicare regulations, and process optimization, typically supported by a bachelor's degree in healthcare or business administration. Familiarity with CMS guidelines, claims processing systems, and compliance management tools is essential. Strong leadership, analytical thinking, and effective communication distinguish top performers in this role. These skills are crucial for ensuring regulatory compliance, operational efficiency, and high-quality service in the management of Medicare programs.

What are some of the main challenges faced by a Medicare Operations Manager, and how can they be addressed?

A Medicare Operations Manager often encounters challenges such as staying current with frequently changing CMS regulations, ensuring data accuracy, and coordinating across multiple departments to maintain compliance and operational efficiency. Addressing these challenges involves maintaining robust communication channels, investing in ongoing staff training, and leveraging technology to automate reporting and auditing processes. Building strong relationships with compliance, IT, and customer service teams also helps streamline workflows and foster a proactive approach to problem-solving.

What is the difference between Medicare Operations Manager vs Medicare Claims Supervisor?

AspectMedicare Operations ManagerMedicare Claims Supervisor
Required CredentialsBachelor's degree in healthcare administration or related field; certifications like CPC or CMS certificationsHigh school diploma or associate's; certifications like CPC or claims-specific training
Work EnvironmentOversees multiple departments, manages staff, and ensures compliance in healthcare organizationsSupervises claims processing teams, reviews claims, and ensures accuracy in claims submission
Employer & Industry UsageHealth insurance companies, Medicare administrative contractors, healthcare providersHealth insurance companies, Medicare contractors, claims processing centers

The Medicare Operations Manager focuses on overseeing overall Medicare operations, including compliance and staff management, while the Medicare Claims Supervisor concentrates on managing claims processing and accuracy. Both roles require knowledge of Medicare policies and certifications like CPC, but differ in scope and responsibilities.

What are popular job titles related to Medicare Operations Manager jobs in Virginia?

For Medicare Operations Manager jobs in Virginia, the most frequently searched job titles are:

Infographic showing various Medicare Operations Manager job openings in Virginia as of August 2026, with employment types broken down into 86% Full Time, 12% Part Time, and 2% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $62,912 per year, or $30.2 per hour.

Reimbursement Billing Supervisor

Prince William County, VA

VA โ€ข On-site

$76K - $133K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post hasย expired 1 day ago.ย Applications are no longer accepted.


Job description

Salary: $76,069.50 - $133,282.50 Annually
Location : Prince William County, VA
Job Type: Full-Time (FT)
Job Number: 202610790
Department: COMMUNITY SERVICES
Division: Administrative Services
Opening Date: 08/20/2026
Closing Date: 9/3/2026 11:59 PM Eastern
GRADE: C43
Hiring Salary: $76,069.50 - $104,676.00 Annually
Introduction
Prince William County Community Services (CS) is seeking an experienced, collaborative, and results-driven Fee Billing Supervisor to lead our Behavioral Healthcare Reimbursement team. We are a large, community-based behavioral health organization dedicated to providing high-quality services while ensuring accurate, timely, and compliant reimbursement for the care we provide.
This leadership position supervises eight (8) reimbursement professionals and is responsible for overseeing the insurance accounts receivable process and the daily import of electronic payments into the agency's Electronic Health Record (EHR) for all Outpatient and Community Mental Health Rehabilitative services. The Fee Billing Supervisor plays a critical role in ensuring the integrity of the revenue cycle, maximizing reimbursement, maintaining regulatory compliance, and supporting the financial health of the organization.
About the Role
The Fee Billing Supervisor provides day-to-day leadership and oversight of the behavioral health revenue cycle, ensuring efficient billing operations, timely collections, and compliance with all federal, state, Medicaid, Medicare, Managed Care Organization (MCO), commercial insurance, and payer requirements.
Key responsibilities include:
  • Supervise, mentor, train, and evaluate a team of eight reimbursement professionals through regular supervision, coaching, performance management, and annual evaluations.
  • Plan, prioritize, and assign staff work to ensure timely, accurate billing, reimbursement, and account collection activities.
  • Oversee all billing operations, including medical coding, charge entry, claims submission, payment posting, accounts receivable management, denial resolution, and reimbursement activities.
  • Manage the daily import and reconciliation of electronic payments into the EHR, ensuring accurate posting and client account updates.
  • Monitor clearinghouse activity and insurance payer portals to identify claim issues, payment variances, and reimbursement opportunities.
  • Review electronic payment distribution, claims submissions, and reimbursement activities to ensure accuracy, completeness, and timeliness.
  • Analyze billing transactions, claims, and payment activity to ensure accurate coding, complete documentation, and timely reimbursement.
  • Review unworked claim edits, claim rejections, and denied claims; identify trends, determine root causes, and implement corrective actions to improve reimbursement outcomes.
  • Monitor billing matrix errors, denial trends, and unpaid services while collaborating with staff and program leadership to resolve recurring issues.
  • Oversee aged accounts receivable to ensure timely follow-up, timely collection efforts, and reduction of outstanding balances.
  • Oversee the Medicaid authorization process to ensure authorizations are requested, tracked, and submitted within required timeframes.
  • Prepare, analyze, and present accounts receivable, aging, clearinghouse, debt collection, reimbursement, and other financial reports in collaboration with the Revenue Business Services Administrator.
  • Compile and analyze statistical and financial data required for agency leadership, federal and state reporting, and payer compliance.
  • Complete monthly financial reconciliations between the EHR and the County financial system.
  • Audit daily deposits and reimbursement transactions to ensure financial accuracy and accountability.
  • Prepare monthly financial and operational reports for agency leadership.
  • Participate in recurring meetings with Virginia Medicaid, Managed Care Organizations (MCOs), commercial insurance representatives, and other payers to address contract performance, billing compliance, reimbursement issues, and claims denials.
  • Evaluate revenue cycle processes for effectiveness and efficiency, recommending and implementing process improvements that enhance billing accuracy, strengthen internal controls, improve staff productivity, and maximize reimbursement.
  • Stay current on changes to Medicaid, Medicare, commercial insurance, and other payer regulations, ensuring agency compliance with evolving billing requirements.
  • Provide guidance and technical assistance to reimbursement staff, program managers, clinicians, and administrative personnel regarding billing requirements, documentation standards, coding, reimbursement policies, and regulatory compliance.
  • Ensure agency compliance with all applicable federal, state, local government, Medicaid, Medicare, and payer billing regulations, policies, and contractual requirements.
  • Perform other duties as assigned.

The Successful Candidate Will Have
The ideal candidate is an experienced healthcare revenue cycle leader with strong knowledge of behavioral healthcare billing, Medicaid reimbursement, insurance claims management, and regulatory compliance. They possess exceptional analytical, organizational, and leadership skills and can build collaborative relationships with clinical staff, fiscal leadership, and external payer representatives.
If you are a collaborative leader passionate about improving revenue cycle performance, supporting staff development, and ensuring compliance in a behavioral healthcare environment, we encourage you to apply to join the Prince William County Community Services team.
Minimum Requirements:
  • High school diploma or G.E.D.
  • 6 years of related experience in behavioral healthcare billing and revenue cycle experience.

Preferences:
  • Experience supervising medical billing, accounts receivable, or healthcare reimbursement staff.
  • Knowledge of behavioral healthcare billing, medical coding, revenue cycle management, and insurance reimbursement processes.
  • Experience working with Virginia Medicaid (DMAS), Managed Care Organizations (MCOs), Medicare, and commercial insurance billing requirements.
  • Strong understanding of federal and state healthcare reimbursement regulations and compliance standards.
  • Excellent analytical, problem-solving, organizational, and communication skills.
  • Proficiency with Electronic Health Records (EHRs), clearinghouses, insurance portals, Microsoft Office applications, and financial reporting tools.
  • The ability to manage multiple priorities while maintaining exceptional attention to detail and delivering outstanding customer service to both internal and external stakeholders.

Special Requirements (if applicable):
  • Must possess a valid driver's license.
  • Must pass DMV record check.
  • Must pass TB test.
  • Offer of employment is contingent upon the candidate passing a fingerprint-based national criminal history record check.

Child Protective Services Requirements: effective 1999, mandated by the Virginia Department of Behavioral Health and Developmental Services (DBHDS) in accordance with 12VA35-105-400 rules and regulations for DBHDS Licensed Providers and related to the Criminal Registry Checks, a search of the registry of founded complaints of child abuse and neglect will be conducted by the Virginia Department of Social Services.
Work Schedule: The work hours will be Monday through Friday, 8:30 AM - 5:00 PM, with a 1-hour lunch. The position will work at 14011 Worth Avenue, Woodbridge, Virginia, with at least one day at the Manassas, Virginia CS location.
Hiring Salary Range: $76,069.50 - $104,676.00 Annually
We also offer great benefits, including:
  • Retirement from the Virginia Retirement System (VRS)
  • 401a and 457 retirement savings and investment plans
  • Paid Annual Leave
  • Paid Personal Leave
  • Paid Sick Leave
  • Paid Holidays
  • Optional Group Medical and Dental Health Plans
  • Optional Group Life Insurance
  • An Employee Assistance Program (EAP)
  • Career Development Opportunities

Full-time positions with Prince William County Government qualify for Public Service Loan Forgiveness. Click here for PSLF for additional information.
NOTE: The above position description is intended to represent only the key areas of responsibility; specific position assignments will vary depending on the department's business needs. To view the class description in its entirety, click here.
Prince William County is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the County will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer.
SEE YOURSELF HERE!
Prince William County Government offers medical plans with corresponding pharmacy and basic vision coverage, as well as dental plans and a separate vision plan.
Full-time and part-time Prince William County Government employees are eligible to participate in our plans; however, the level and cost of benefits depends on the classification of the position.
The following positions do not accrue leave and are not eligible for holidays or other fringe benefits:
  • Temporary
  • Provisional
  • Seasonal employees
Click on the link below to explore our plans and rates.
01
By submitting this application, I understand the following: 1) Only the information provided on my application is used to determine my qualifications; 2) My resume will not substitute for the education, work experience, and required fields on the Prince William County application; 3) Only responses to Supplemental Questions that can be verified in my submitted education and work experience will be credited and 4) If selected, my employment dates will be verified for the past three (3) years (if applicable), with a required reference from my current or most recent employer.
  • Yes, I acknowledge and understand the above statement and wish to continue in this process.
  • No, I do not wish to proceed any further in this process.

02
Please select your highest level of education.
  • Master's Degree or Higher
  • Bachelor's Degree
  • Associate's Degree
  • High School Diploma or GED
  • None of the above

03
This position requires a minimum of six (6) years of analytical, paraprofessional, accounts receivable, healthcare billing, or administrative management experience. Please quantify your experience.
  • More than 10 years
  • 7 - 10 years
  • 6 years
  • Less than 6 years
  • None of the above

04
Which of the following have you led or significantly contributed to for business process improvement? (Select all that apply)
  • Improved billing workflows
  • Reduced claims denials
  • Reduced accounts receivable aging
  • Increased reimbursement collections
  • Implemented new billing software
  • Developed billing procedures
  • Trained billing staff
  • Developed performance metrics
  • None of the above

05
Please select your level of professional experience managing multiple priorities while maintaining attention to detail and providing excellent customer service to internal and external stakeholders.
  • Extensive experience: 5 or more years of professional experience consistently applying all skills in a work environment.
  • Significant experience: 3-4 years of professional experience demonstrating these skills.
  • Some experience: 1-2 years of professional experience demonstrating these skills.
  • Limited experience: Less than 1 year of professional experience demonstrating these skills.
  • No experience: No professional experience demonstrating these skills.

06
Please select your level of professional experience demonstrating strong analytical, problem-solving, organizational, and communication skills.
  • Extensive experience: 5 or more years of professional experience consistently applying all four skills in a work environment.
  • Significant experience: 3-4 years of professional experience applying most or all of these skills.
  • Some experience: 1-2 years of professional experience applying some or all of these skills.
  • Limited experience: Less than 1 year of professional experience applying some or all of these skills.
  • No experience: No professional experience demonstrating these skills.

07
How many years of experience do you have supervising employees responsible for healthcare billing, reimbursement, or accounts receivable functions?
  • More than 10 years
  • 7 - 10 years
  • 4 - 6 years
  • 1 - 3 years
  • Less than 1 year
  • None of the above

08
What is the largest number of employees you have directly supervised?
  • 10 or more employees
  • 7 - 9 employees
  • 4 - 6 employees
  • 1 - 3 employees
  • None of the above

09
Please select all environments in which you have direct experience with healthcare billing or accounts receivable.
  • Local Government
  • State Government
  • Federal Government
  • Private Healthcare
  • Community Services Board
  • Behavioral Health
  • Hospital
  • Physician Practice
  • Other Healthcare
  • None of the above

10
Please select all payer types with which you have direct billing experience.
  • Virginia Medicaid (DMAS)
  • Medicaid Managed Care Organizations (MCOs)
  • Medicare
  • Commercial Insurance
  • Self-Pay
  • Grant-funded Services
  • None of the above