Position Summary

The Billing Manager will oversee the accurate and timely processing of billing for behavioral health and healthcare services while promoting financial efficiency and ensuring compliance with applicable federal and New Jersey regulations.

This role will provide leadership to the billing team and work closely with clinical, administrative, finance, credentialing, and compliance departments. This position will oversee the billing process from insurance verification and authorization through claim submission, payment posting, denial management, accounts receivable, and collections.

Essential Duties and Responsibilities

Billing and Revenue Cycle Management

• Oversee the organization’s day-to-day billing and revenue cycle operations.
• Ensure claims are submitted accurately and within required timeframes.
• Monitor the billing process from charge entry through payment and account resolution.
• Oversee accounts receivable and follow up on outstanding balances.
• Monitor claim denials and identify recurring issues affecting reimbursement.
• Establish procedures to improve claim accuracy and reduce billing errors.
• Ensure patient accounts and insurance information are accurately maintained.
• Review payment postings and adjustments for accuracy.
• Coordinate with staff to resolve billing discrepancies and payment issues.

Insurance and Claims Management

• Maintain knowledge of commercial insurance and government payer requirements applicable to the organization.
• Monitor payer contracts and reimbursement requirements.
• Assist with credentialing and enrollment processes when needed.
• Communicate with insurance representatives regarding claims and reimbursement issues.
• Ensure billing practices remain consistent with payer requirements.

Compliance and Risk Management

• Ensure billing practices comply with applicable federal and New Jersey laws and regulations.
• Maintain appropriate billing policies and procedures.
• Monitor billing activities for potential compliance concerns.
• Support accurate documentation and recordkeeping related to billing and reimbursement.
• Maintain appropriate confidentiality and safeguard protected health information.
• Work with leadership to address identified compliance issues.
• Stay informed about changes to healthcare billing requirements and reimbursement regulations.

Leadership and Staff Management

• Supervise and provide direction to billing department employees.
• Establish departmental goals and performance expectations.
• Train and develop billing staff on organizational procedures and payer requirements.
• Conduct regular performance reviews and provide ongoing coaching.
• Develop efficient workflows and assign responsibilities appropriately.

Reporting and Financial Analysis

• Prepare and present regular billing and revenue cycle reports to leadership.
• Monitor key performance indicators including accounts receivable aging, collection rates, denial rates, and claim turnaround times.
• Maintain accurate records and documentation for financial reporting and audits.

 Minimum Qualifications

• Advanced MD experience required.
• Bachelor’s degree in Finance, Business, Accounting or a closely related field required.
• Travel to multiple facilities is required
• Minimum of 5 years of experience in healthcare billing.
• Previous supervisory or management experience required.
• Knowledge of healthcare billing compliance and HIPAA requirements.
• Strong analytical, organizational, and problem-solving skills.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities and meet deadlines.
• Proficiency with electronic health records and billing systems.
• Experience with Medicaid, Medicare, commercial insurance, and managed care organizations preferred.

Benefits

• 401(k) Retirement Plan: 401(k) plan with company matching contributions, available after completing one year of service and meeting applicable vesting requirements.
• Health Insurance: Company contributes 50% toward the employee’s health insurance premium.