Responsible for all aspects of behavioral health billing operations within healthcare revenue cycle management, with a focus on mental health, substance use disorder, and related services. The role includes charge entry, claim submission, payment posting, denial management, collections, records management, and reimbursement follow-up with third-party payers. It also involves supervision of subordinate billing staff and coordination with leadership, insurance carriers, managed care organizations, county departments, and state agencies.
The position requires applying federal, state, county, and institutional regulations to billing and claims processes, preparing monthly billing and revenue reports, and monitoring revenue cycle performance metrics.
Required knowledge and skills
- Strong knowledge of NYS Medicaid behavioral health billing requirements and procedures
- Strong knowledge of CPT, HCPCS, and ICD-10 coding
- Knowledge of managed care authorization and claims processes
- Knowledge of electronic health records and billing systems
- Knowledge of revenue cycle management best practices
- Ability to manage, analyze, and reconcile billing and payment detail accurately
- Ability to interpret insurance documents, remittances, denials, and explanation of benefits
- Ability to organize records, prepare reports, and use spreadsheets and databases
- Ability to maintain confidentiality of medical records
- Strong communication, judgment, accuracy, and attention to detail
Minimum qualifications
- Associate degree or higher in a closely related business or medical field, such as Healthcare Administration or a Medical Biller program, plus 2 years of full-time paid experience in behavioral health billing, medical billing and coding, or billing and claims management; or
- High school diploma or equivalent plus 4 years of full-time paid experience in the same areas
Special requirement
- Current CPC, CPB, CCS, or similar AAPC-approved certification required at appointment and maintained through annual continuing education
Location
New York, US
Employment Type
Full-time
Experience Level
Manager
Salary Range
$51,039 - $60,429
Remote work allowed
No
Posted
1 month ago