billing manager

FAMILY TIES, INC.

MUST HAVE MEDICAID &amp; MENTAL HEALTH BILLING EXPERIENCEAbout the RoleWe are seeking an experienced and highly organized Behavioral Health Billing Manager to join our growing team. This role is critical to ensuring accurate, compliant, and timely billing for behavioral health services. The ideal candidate is detail-oriented, proactive, and well-versed in Medicaid and Private insurance mental health billing, DBHDD policies and procedures, and provider credentialing.If you thrive in a fast-paced healthcare environment, enjoy problem-solving, and understand the importance of compliance in behavioral health services, this role is an excellent fit. This role goes beyond billing&mdash;it directly supports access to quality behavioral health care. You&rsquo;ll be part of a supportive, mission-driven team where your expertise ensures compliance, financial stability, and a smooth experience for both clients and providers. Your work truly makes a difference.Key ResponsibilitiesBilling &amp; Revenue Cycle Management<ul><li>Manage and maintain accurate, up-to-date client billing records</li><li>Review referrals, authorizations, and clinical documentation for billing compliance</li><li>Submit and track Medicaid and commercial insurance claims for mental health services</li><li>Ensure compliance with DBHDD, Medicaid, and payer-specific billing rules</li><li>Transfer and verify billing and insurance data with precision</li><li>Monitor accounts receivable and follow up on unpaid or denied claims</li><li>Investigate and resolve billing discrepancies and payment issues</li><li>Set up and manage payment plans when necessary</li><li>Send professional, timely payment reminders (friendly but firm)</li></ul>Insurance &amp; Compliance<ul><li>Verify insurance eligibility, benefits, and authorizations</li><li>Navigate Medicaid, HMOs, PPOs, and state-funded behavioral health programs</li><li>Stay current on DBHDD policies, Medicaid updates, and payer requirements</li><li>Serve as a point of contact for billing-related questions from clients and insurance companies</li></ul>Credentialing &amp; Provider Support<ul><li>Manageemployee and provider credentialing for Medicaid and other payers</li><li>Track credentialing and recredentialing timelines to ensure uninterrupted billing</li><li>Maintain organized credentialing files and documentation</li></ul>Required Qualifications<ul><li>Minimum 2+ years of Medicaid billing experience (REQUIRED)</li><li>Mental health / behavioral health billing experience (REQUIRED)</li><li>Strong knowledge of DBHDD policies and procedures (REQUIRED)</li><li>Experience with employee/provider credentialing (REQUIRED)</li><li>Bachelor&rsquo;s degree in Accounting, Healthcare Administration, Finance, Business, or related field (preferred)</li><li>Proficiency in Microsoft Office (Excel required); QuickBooks experience strongly preferred</li><li>Excellent multitasking, time management, and organizational skills</li><li>Ability to work independently and take initiative</li><li>Strong communication and customer service skills</li><li>Ability to clearly explain billing and insurance information to clients and payers</li><li>High attention to detail and strong problem-solving skills</li></ul>Benefits<ul><li>401(k)</li><li>Health Insurance</li><li>Dental Insurance</li><li>Vision Insurance</li><li>Paid Time Off</li><li>Referral Program</li></ul>Why Join Us? This is more than just numbers and spreadsheets&mdash;it&rsquo;s about helping people get the care they need, ensuring their billing experience is smooth, and making sure nothing falls through the cracks. You'll be part of a supportive team where your work truly matters.Job Type: Full-timePay: $45,000.00 - $50,000.00 per yearBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Referral program</li><li>Vision insurance</li></ul>Experience:<ul><li>Behavioral Health Billing : 2 years (Required)</li></ul>Ability to Commute:<ul><li>Atlanta, GA 30328 (Required)</li></ul>Work Location: Hybrid remote in Atlanta, GA 30328

Behavioral Health Billing Manager

JSG Partners

Immediate Opening for a Billing Manager in Duncanville, Texas with a privately owned Ophthalmology Practice<ul><li>Must have prior experience as a Billing Manager in and eyecare or similar setting</li><li>Must have leadership experience</li><li>Minimum of Associates Degree</li></ul>Job Type: Full-timePay: $65,000.00 - $85,000.00 per yearWork Location: In person

Medical Billing Manager for an Ophthalmology Practice

Diglip

We are seeking a highly experienced Laboratory Billing Specialist / RCM Manager to oversee and optimize all aspects of our diagnostic laboratory billing operations. This role will act as the internal billing authority, working closely with our third-party billing company to ensure clean claim submission, minimize denials, and maximize reimbursement.The ideal candidate must have deep expertise in clinical laboratory billing, coding, payer guidelines, and denial management, and should be capable of identifying gaps, resolving issues, and implementing process improvements.Key Responsibilities<ul><li>Oversee and audit the performance of the external billing company</li><li>Review and ensure clean claim submission (first-pass resolution)</li><li>Analyze and resolve denials (CO-45, CO-97, CO-16, PR-96, etc.)</li><li>Identify root causes of denials and implement corrective workflows</li><li>Monitor AR (Accounts Receivable) and aging reports</li><li>Ensure proper usage of CPT codes, ICD-10 codes, modifiers (e.g., 59, 91, 25)</li><li>Validate medical necessity compliance (LCD/NCD guidelines)</li><li>Manage payer-specific requirements (Medicare, Medicaid, BCBS, Aetna, UHC, etc.)</li><li>Work on eligibility verification and benefits investigation</li><li>Review EOBs/ERAs and payment posting accuracy</li><li>Ensure proper credentialing and enrollment (NPI, CLIA, PECOS, CAQH)</li><li>Maintain compliance with HIPAA and CMS billing regulations</li><li>Coordinate with lab operations for proper test coding &amp; panel setup</li><li>Optimize workflows for high-volume tests (CBC, CMP, Ferritin, Toxicology, etc.)</li><li>Track rejection trends and clearinghouse errors</li><li>Generate weekly/monthly billing performance reports</li><li>Implement strategies to reduce write-offs and maximize collections</li></ul>Required Skills &amp; ExpertiseCore Billing Knowledge<ul><li>Strong understanding of Laboratory Billing (Clinical &amp; Toxicology preferred)</li><li>Expertise in:</li><li>CPT / HCPCS coding</li><li>ICD-10 diagnosis coding</li><li>Modifiers usage</li><li>Medical necessity rules</li><li>Hands-on experience with:</li><li>Denial Management &amp; Appeals</li><li>AR Follow-ups</li><li>Insurance Verification</li><li>Charge Entry &amp; Payment Posting</li></ul>Technical &amp; System Skills<ul><li>Experience with LIS (Laboratory Information Systems) and billing software</li><li>Familiarity with Clearinghouses (Office Ally, Change Healthcare, etc.)</li><li>Knowledge of EDI transactions (837, 835, 270/271)</li><li>Ability to audit data between LIS and Billing Systems</li><li>Strong Excel / Google Sheets skills for reporting &amp; analytics</li></ul>Payer &amp; Compliance Knowledge<ul><li>Experience handling:</li><li>Medicare / Medicaid billing</li><li>Commercial insurance (BCBS, Aetna, UHC, Cigna, etc.)</li><li>Understanding of:</li><li>LCD/NCD policies</li><li>Frequency limitations</li><li>Bundling &amp; unbundling rules</li><li>Familiarity with CLIA regulations for lab billing</li></ul>Credentialing &amp; Enrollment<ul><li>Experience with:</li><li>Provider Enrollment (PECOS, CAQH)</li><li>NPI registration and maintenance</li><li>CLIA certification handling</li><li>Ability to ensure lab is properly enrolled with all payers</li></ul>Preferred Qualifications<ul><li>Experience working with high-complexity labs or toxicology labs</li><li>Prior experience managing or auditing outsourced billing teams</li><li>Knowledge of HL7 integrations and lab-machine workflows</li><li>Certification such as:</li><li>CPB (Certified Professional Biller)</li><li>CPMA / CPC (AAPC)</li></ul>Key Performance Indicators (KPIs)<ul><li>Reduction in denial rate (%)</li><li>Increase in clean claim rate</li><li>Improvement in AR days</li><li>Recovery of underpaid / denied claims</li><li>Accuracy in coding and billing compliance</li></ul>Note: Candidates without hands-on lab billing experience will not be considered.Job Type: Full-timePay: Rs150,000.00 - Rs200,000.00 per monthApplication Question(s):<ul><li>How many years of US laboratory billing experience do you have?</li><li>Have you worked with denial codes like CO-45, CO-97, CO-16, PR-96?</li><li>Are you comfortable working onsite and night shifts (US hours)?</li></ul>Work Location: In person

Laboratory Billing Specialist / Revenue Cycle Manager (RCM)

Santa Fe Care Center

Position Purpose: 
The Business Office Manager maintains complete and systematic records of the financial transactions and a variety of other business office duties.
 
Essential Functions of Position: 
<ul>
<li>Responsible for management, oversight, and completion of billing process consistent with company policies, procedures and standards.</li>
<li>Manages and oversees business office functions in records, accounting, billing, accounts payable, and accounts receivable, inventory and supply management.</li>
<li>Directs billing functions, including accurate invoicing of all client services. Ensures reimbursement from governmental payers, insurance 9ompanies, client's or client representatives in compliance with company standards.</li>
<li>Ensures all bills are paid in a timely an accurate manner.</li>
<li>Monitors services provided will be reimbursable (monitors tile levels, applied incomes, etc.)</li>
<li>Manages the Petty Cash/Credit Card Payments.</li>
<li>Maintains all required and appropriate, logs.</li>
<li>Consults with department heads to resolve errors in accounts.</li>
<li>Reconciles accounts and provides financial reports to Administrator upon request.</li>
<li>Tracks census, census summary report, and obtains 24-hour nursing report from charge nurse.</li>
<li>Interacts with the general public, visitors, families and residents.</li>
<li>May act in an administrative capacity if so, designated in the absence of Administrator.</li>
<li>Receives and receipts payments in an accurate and timely manner. Records the details of financial transactions in appropriate journals and ledgers. Summarizes and balances entries recording on individual journals and ledgers.</li>
<li>Receipts, posts, and maintains accurate individual resident trust ledgers to meet Federal and State regulations. Reconciles to bank statements.</li>
<li>Maximizes office productivity through proficient use of appropriate software applications.</li>
<li>Formulates procedures for systematic! retention, protection, retrieval, transfer, and disposal of personnel and resident financial records.</li>
<li>Understands and adheres to the guidelines of "Residents Rights".</li>
<li>Performs additional duties as assigned.</li>
<li>Process insurance claims to various types of insurances and self-pay patients</li>
<li>Research and communicate with insurances and third parties regarding claim denials</li>
<li>Make necessary billing/coding corrections and refile denied claims for reprocessing</li>
<li>Process and post patient payments</li>
<li>Answer patient inquiries regarding account status</li>
<li>Identify, research and resolve patient billing issues</li>
<li>Contact patients regarding collections of past due account balances</li>
<li>Work with patients to establish self-pay arrangements and payment plans</li>
<li>Review and research bad address files</li>
<li>Assist with provider insurance credentialing duties</li>
<li>Assist with Sliding Fee Scale application and audit processes</li>
<li>Assist with reports to maintain federal funding as requested</li>
<li>Participate is staff meetings and other meetings as instructed</li>
<li>Adhere to the Mission and Values of SFCC.</li>
<li>May be asked to perform other duties that align with mission, including but not limited to participation on clinical committees, providing education, Quality Review and/or other activities.</li>
</ul>
Education / Requirements: 
<ul>
<li>Excellent communication skills</li>
<li>Attention to detail</li>
<li>Computer knowledge</li>
<li>Medical Terminology</li>
<li>Experience in coding and charge entry</li>
</ul>
Education / Requirements: 
<ul>
<li>A minimum of two years college required with emphasis on accounting and business. Must have 3 plus years business office experience. Must have working knowledge of bookkeeping or accounting principles, preferably in a healthcare setting to include Medicare, Medic id and third-party billing.</li>
</ul>
Need to have experience in Medicare and Medicaid and insurance billing.

Business Office Manager

La Rabida Children's Hospital

<div><div><div><h2 class="jobSectionHeader">Company Description</h2></div><div>
La Rabida Children&rsquo;s Hospital provides specialized, family-centered health care to children with medically complex conditions, disabilities, and chronic illness. Through expertise, compassion, and advocacy we help children and their families reach their fullest potential, regardless of their ability to pay.
Our not-for-profit hospital, licensed for 49 beds, helps transition children from neonatal or pediatric intensive care to home, by providing medical, rehabilitative and developmental care, and by training families to continue treatments and manage the necessary equipment in the home. La Rabida also provides extensive rehabilitation for those recovering from wounds or burns and treatment for exacerbations of chronic conditions.
The hospital&rsquo;s enhanced pediatric patient-centered medical home provides primary care to children with complex medical conditions and their siblings. Children with medical homes elsewhere come to La Rabida for specialty services. La Rabida offers a wide range of specialty services provided to children with sickle cell disease, diabetes, and many others. Children are supported in their emotional and developmental growth, particularly in cases where such growth has been interrupted by accident or disease.
Finally, La Rabida provides forensic and treatment services for children exposed to abuse and neglect, comprehensive assessments for wards of the state, early intervention for children between 0 and 3 years of age. Care coordination services for medically complex children are also provided for those who are covered by a health plan and receive care from providers in Cook County</div></div><div><div><h2 class="jobSectionHeader">
Job Description</h2></div><div>
Position Summary
The Revenue Cycle Manager is responsible for the strategic oversight and day-to-day management of the hospital&rsquo;s financial health. This role leads the Billing and Coding teams in a specialized pediatric environment, ensuring high-quality charge capture, accurate coding, and timely reimbursement.
A critical component of this role includes leading the department through a transition from legacy systems (Meditech and Athena) to an Epic platform, while maintaining expert compliance with Illinois Medicaid regulations and pediatric-specific billing requirements.
Key Responsibilities
Leadership &amp; Supervision<ul><li>Direct Supervision: Manage, mentor, and evaluate the performance of Billing and Coding specialists.</li><li>Staff Development: Provide continuous training on pediatric-specific coding (ICD-10-CM, CPT, HCPCS) and evolving payer regulations.</li><li>Workflow Optimization: Establish departmental KPIs (e.g., Days in AR, Clean Claim Rate, Denial Rate) and hold staff accountable to production standards.</li></ul>
Systems &amp; Implementation<ul><li>Legacy Management: Oversee current revenue operations within Meditech (Hospital/Inpatient) and Athena (Ambulatory/Outpatient) to ensure no revenue leakage during the transition.</li><li>Epic Implementation: Serve as the Revenue Cycle Subject Matter Expert (SME) for the Epic go-live. Duties include workflow design, system testing, data migration validation, and end-user training for the billing/coding modules.</li><li>Interoperability: Ensure seamless data flow between legacy archives and the new Epic environment.</li></ul>
Illinois Medicaid &amp; Pediatric Compliance<ul><li>Regulatory Expertise: Serve as the primary resource for Illinois Medicaid (HFS) guidelines, including Managed Care Organizations (MCOs) and the All Kids program.</li><li>Pediatric Billing: Manage complex pediatric billing scenarios, including neonatal care, rehabilitative therapy, and long-term pediatric chronic care.</li><li>Audit &amp; Compliance: Conduct internal audits to ensure coding accuracy and compliance with state and federal healthcare laws.</li></ul>
Financial Operations<ul><li>Denial Management: Analyze denial trends and implement root-cause solutions to reduce rejections from Illinois Medicaid and commercial payers.</li><li>Reporting: Prepare monthly financial reports and dashboards for senior leadership regarding AR aging and cash collection targets.</li><li>Liaison: Act as the bridge between clinical departments and the finance office to ensure clinical documentation supports billed services</li></ul></div></div><div><div><h2 class="jobSectionHeader">
Qualifications</h2></div><div>
Qualifications<ul><li>Education: Bachelor&rsquo;s degree in Healthcare Administration, Finance, or a related field (Master&rsquo;s preferred).</li><li>Experience: * Minimum 5+ years in Healthcare Revenue Cycle Management.</li></ul>
 o Proven experience in a supervisory role overseeing billing and coding professionals.
 o Direct experience with Illinois Medicaid reimbursement and policy.<ul><li>Technical Skills: * Proficiency in Meditech and AthenaIDX/One.</li></ul>
 o Epic Certification or previous experience leading an Epic Implementation (Resolute Hospital Billing/Professional Billing) is highly preferred.<ul><li>Certifications: CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or CRCR (Certified Revenue Cycle Representative) preferred</li></ul> 
Required Competencies<ul><li> Change Management: Ability to lead a team through the technical and emotional challenges of a major EHR transition.</li><li>Analytical Thinking: Deep understanding of healthcare data to identify trends in underpayments or billing errors.</li><li>Pediatric Focus: Sensitivity to the unique billing needs of a small, 39-bed children&rsquo;s facility.</li></ul></div></div><div><div><h2 class="jobSectionHeader">
Additional Information</h2></div><div>
La Rabida Children&rsquo;s Hospital is very proud to be an Equal Employment Opportunity Employer<div></div>
La Rabida is a place unlike any other. We understand the needs of families with children dealing with the most serious or complicated of conditions. With teams of the best healthcare providers in Chicago, we give continuous, comprehensive care, education, and support, helping families face their unique obstacles head-on.
La Rabida Children&rsquo;s Hospital is very proud to be an Equal Employment Opportunity Employer.</div></div></div>

Manager of Revenue Cycle

Nexion Health, Inc.

Must have LTC/SNF experience with Medicare, Medicaid, and Managed Care!
 
Starting Rate: 
Pay based on experience
 
INDOTH
 
Nexion is a "Great Place to Work" because we provide: 
Free employee and family telehealth immediately upon hire
 
Medical / Dental / Vision Care
 
Early Pay
 
FSA / HSA / 401k
 
Educational Advancement
 
Scholarship for employees and dependents
 
Emergency Relief
 
Job Responsibilities
 
The Business Office Manager (BOM) is responsible to bill facility charges to the appropriate payor, collect outstanding Accounts Receivables, and oversee the resident trust fund in accordance with Nexion Corporate policy and applicable federal, state, and local regulations. This position requires a minimum of 1 year Medicare, Medicaid and Managed Care billing experience in a SNF setting.
 
EOE M/F/D/V

Business Office Manager - SNF/LTC

Spring Meadows Health & Rehabilitation

<div>Now Hiring: Business Office Manager
Spring Meadows Health &amp; Rehabilitation | Clarksville, Tennessee 
Full-Time
We are seeking an experienced and detail-oriented Business Office Manager (BOM) to join our skilled nursing facility. This role is vital to ensuring accurate financial operations, strong resident account management, and compliance with state and federal regulations.
What You&rsquo;ll Love:<ul><li>
Competitive pay</li><li>
Paperless, quick onboarding</li><li>
Comprehensive benefits (health, dental, vision, retirement plan)</li><li>
Predictable scheduling and flexibility (e.g., full-time, part-time, PRN options)</li><li>
Paid time off, holiday pay</li><li>
Generous employee referral program</li><li>
Annual performance reviews and competitive bi-annual pay reviews</li><li>
Support for personal well-being (EAP programs, mental health resources)</li><li>
Respectful, supportive leadership and strong focus on teamwork</li><li>
Optimal staff-to-patient ratios to prevent burnout</li><li>
Opportunities for advancement</li><li>
Tuition reimbursement, training programs, and CEU support</li><li>
Strong mentorship and orientation programs</li><li>
Strong school partnerships</li><li>
360 communications for staff, residents &amp; families</li></ul> 
Key Responsibilities:<ul><li>
Oversee daily business office operations, including billing, collections, and resident trust accounts</li><li>
Manage Medicare, Medicaid, private pay, and third-party billing processes</li><li>
Ensure accurate census, admissions, discharges, and payer updates</li><li>
Maintain compliance with federal, state, and facility financial regulations</li><li>
Collaborate with the Administrator, DON, and interdisciplinary team</li><li>
Supervise and support business office staff as applicable</li><li>
Respond to resident and family billing inquiries professionally and timely</li></ul>
Qualifications:<ul><li>
Previous Business Office Manager experience in a skilled nursing or long-term care setting preferred</li><li>
Strong knowledge of Medicare, Medicaid, and insurance billing</li><li>
Excellent organizational, communication, and problem-solving skills</li><li>
Ability to manage multiple priorities in a fast-paced environment</li><li>
Proficient in electronic billing systems and Microsoft Office</li></ul>
Salary/ Wage Range
Compensation for the role will depend on several factors, including a candidate&rsquo;s qualifications, skills, competencies and experience, and may fall outside of the range shown.
Your next shift could change a life. Apply today!
We are committed to maintaining a diverse and inclusive workplace. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for our job opportunities.</div>

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