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AI Summary

The Billing Manager oversees the daily operations of the billing department, focusing on collections, accounts receivable reduction, and HIPAA compliance. This role also involves team development, process optimization, and serving as a liaison between executive leadership and billing staff.

Job Summary

The Billing Manager is responsible for managing all activities of the Billing Department within the Revenue Cycle, with a strong emphasis on collections, reducing accounts receivable (A/R), and ensuring compliance with HIPAA guidelines and company policies. This role also focuses heavily on team development and process improvement to meet departmental goals and performance standards.

Essential Duties and Responsibilities

  • Oversee day-to-day operations of the billing team, including workflow management, staffing, training, and disciplinary actions.
  • Coordinate billing needs and onboarding processes for newly acquired centers and DeNovo facilities.
  • Monitor payment trends; evaluate and implement changes to billing and collections strategies to improve cash flow.
  • Ensure HIPAA compliance across all billing activities and implement regulatory updates in a timely manner.
  • Work with Payers to resolve complex billing or reimbursement issues beyond standard provider support.
  • Collaborate with Operations to ensure alignment and communication of billing requirements across facilities.
  • Ensure timely month-end close processes and reporting from the billing department.
  • Monitor and optimize the patient account to staff ratio.
  • Escalate reimbursement or payment issues to the VP of RCM proactively.
  • Contribute to and monitor adherence to the departmental budget.
  • Stay up-to-date with industry trends, Federal guidelines, and payer policy changes impacting reimbursement operations.
  • Oversee and continuously improve billing processes and systems for both internal and external stakeholders.
  • Develop and implement training programs to ensure staff proficiency in compliance, billing regulations, and policy adherence.
  • Conduct staff evaluations, set performance goals, and manage individual development plans.
  • Maintain knowledge and compliance with company handbooks, safety, and security policies.
  • Promote professional development through leadership coaching, mentorship, and regular performance audits.
  • Foster collaboration across the organization to improve efficiency and outcomes.
  • Serve as a communication bridge between executive leadership and frontline billing staff.
  • Address and resolve employee relations issues in a timely and constructive manner.

Qualifications and Experience

  • Bachelor’s degree in Healthcare Administration, Business, or related field (preferred).
  • Minimum 5 years of medical billing experience, including 3+ years in a supervisory or management role, ideally in a behavioral health setting.
  • In-depth knowledge of medical billing codes (ICD-10, CPT, HCPCS) and Federal regulations relevant Behavioral Health
  • Proficiency in billing and EMR systems and financial reporting tools.
  • Professional certification preferred: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Biller (CPB).
  • Proven leadership skills with experience managing and developing high-performing teams.
  • Exceptional organizational, analytical, and problem-solving capabilities.
  • Excellent written and verbal communication skills.

Preferred Qualifications

  • Experience with federal ESRD Prospective Payment System (PPS) or behavioral health reimbursement models.
  • Familiarity with behavioral health terminology and physician billing protocols.
  • Ability to interpret complex payer policy changes and translate them into operational strategies.

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