If you are looking to make an impact by helping others, then Preferred Behavioral Health Group is the place for you! By joining our award-winning team, you will become part of the premier behavioral health organization in New Jersey. PBHG is a dynamic and innovative non-profit organization that was proudly named one of "THE BEST PLACES TO WORK IN NEW JERSEY" for 2024 by NJBIZ! Our mission is to change lives and save lives across the state of New Jersey through a Trauma Informed Care culture.

Our staff is at the core of everything we do. We are dedicated to building a diverse team where employees feel a sense of belonging and are valued for their individual contributions. We encourage staff development and embrace a growth mindset. If you are interested in pursuing an exciting and rewarding career while being part of a recognized “Best Place to Work”, please submit your resume today for consideration!

Job Title: Billing Manager

Program: Finance

Location: 52 Hyers Street, Toms River New Jersey 08753

Position Type: Full Time

Minimum Starting Salary: $70,000.00

Job Description/Summary

The Billing Manager is responsible for overseeing and managing all aspects of the organization's billing and collections processes. This position ensures the accurate and timely invoicing, payment processing, and reconciliation of accounts, while also managing billing staff, resolving disputes, and adhering to all applicable financial regulations.

Responsibilities

Daily Operations & Optimization:

• Manages the day-to-day billing and collections cycle, including invoice processing, payment posting, denial management, and reconciliation.
• Proactively reviews outstanding Accounts Receivable (A/R) consistently and meets regularly with programs and leadership to collaborate on collection issues.
• Identifies and implements strategies to reduce days in A/R, improves clean claim rates, and increases first-pass resolution.
• Analyzes billing data and reports to identify trends, pinpoint the root causes of unbilled and denied claims, and finds significant areas for improvement.
• Develops and implements corrective action plans to address billing errors and inefficiencies promptly.
• Proactively manages and resolves complex billing issues, payer disputes, and escalated patient inquiries.
• Creates and monitors processes for addressing growing self-pay balances through payment plans, sliding scales, or grant eligibility criteria.
• Performs all other related duties as assigned.

EHR System Management & Implementation:

• Serves as the primary contact for all EHR billing-related items, responding to issues and adapting to system changes to prevent payer denials or rejections.
• Drives effective utilization and optimization of the EHR's billing, scheduling, and documentation modules to maximize revenue.
• Ensures accurate system setup for new programs, services, and payer contracts within the EHR.
• Continuously uses the EHR, clearinghouse, and all payer systems to monitor payer issues at least monthly.

Compliance & Policy Development:

• Ensures all billing practices adhere to company policies and regulatory requirements, including HIPAA, Medicaid, Medicare, and commercial payer guidelines.
• Develops and implements comprehensive revenue cycle management policies and procedures throughout the organization.
• Stays current with changes in behavioral health coding (CPT, HCPCS, ICD-10) and billing regulations.

Reporting, Analysis & Communication:

• Produces essential reports that measure the status and performance of billing activities.
• Clearly communicates the root cause of billing issues to programs and leadership, collaborating with teams to resolve problems and prevent future denials.
• Reports regularly to the CFO to support the overall strategic financial planning of the agency.
• Implements and monitors key performance indicators (KPIs) to track financial performance and drive accountability within the billing team.

Team Leadership & Collaboration:

• Supervise, monitor, and train the billing staff, ensuring they are properly equipped, accurate, and performing their duties effectively.
• Coordinate and lead monthly meetings with payer representatives to resolve issues and request bulk resubmission of claims as necessary.
• Collaborate closely with clinical staff, operations, and leadership to ensure accurate and timely documentation that supports billing and medical necessity.
• Partner with patient access and intake teams to improve insurance verification, pre-authorization processes, and patient responsibility collections.
• Serve as a vital member of the finance department's management team.

Competencies

• Knowledge of Medicare, Medicaid, and Commercial insurance billing processes, systems and regulations.
• Expertise with all billing requirements, including eligibility, documentation, timeframes, and billing rates.
• Proficiency in billing software and accounting systems required along with proficiency in all Microsoft applications.
• Strong analytical skills are needed for reconciling accounts, identifying trends, and resolving discrepancies.
• The ability to effectively identify and resolve billing issues.
• Excellent communication and interpersonal skills are required for interacting with staff, clients, and other departments.
• Practices a trauma informed philosophy as demonstrated through behaviors and communications, embracing it as a cultural value.

Supervisory Responsibilities:

• Follows hiring, orientation and personnel procedures in accordance with HR policy.
• Monitors, addresses, and documents staff performance on an ongoing basis.
• Completes annual employee performance evaluations.
• Assesses billing and clinical staff training needs and arranges necessary training.
• Ensures all staff supervised meet regulatory standards for training and required credentials.

Qualifications

• Education: Bachelor's degree in Accounting, Finance, or a related field.

• Experience: Minimum of five years’ experience with Medicare, Medicaid, and commercial insurance billing is required, including two years of supervisory experience.

Comprehensive Benefits Package:

o Medical, Dental and Prescription Insurance

o 403(b) Retirement Plan

o Generous Paid Time Off and Paid Holidays

o Long Term Disability Insurance

o Life and AD&D Insurance

o Employee Assistance Program

o Flexible Spending Account and Health Savings Account

o Voluntary Benefits, such as Vision Insurance, Aflac, Pet Insurance

o Staff Training and Development Opportunities

o Employee Referral Bonus program

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