Walker Therapeutic & Educational Programs
Billing and Contracts Manager
Walker Therapeutic & Educational Programs, Needham Heights, Massachusetts, us, 02494
Summary
Billing & Contracts Manager
is responsible for overseeing all aspects of behavioral health billing, payer contract administration, and revenue cycle performance. This role ensures accurate and compliant billing, timely collections, effective denial management, and strong payer relationships while supervising billing staff and partnering closely with clinical, administrative, and finance teams. The ideal candidate brings extensive knowledge of mental health billing regulations, payer requirements, and revenue cycle best practices.
Education Required: Bachelor’s degree in accounting, business, or related field of study.
Experience Required: A minimum of seven years accounting, billing, and contracting experience, including third‑party billing for behavioral health services. Experience with clearinghouses and electronic payment systems. Proficient with Microsoft Office, especially Excel.
Abilities Required: Ability to meet deadlines and follow through with multiple projects simultaneously. Excellent verbal and written communication skills.
Essential Functions
Lead billing and accounts receivable staff, ensuring accurate billing in accordance with the monthly closing schedule and diligent follow‑up on collections.
Maintain billing and collection procedures and support billing staff during volume peaks or absences.
Prepare contracts that support program goals, budgets, and the Agency’s Strategic Plan.
Maintain a contract list including general ledger and UFR mapping.
Update and negotiate annual rates and maintain dialogue with key state agency and third‑party insurance officials regarding new initiatives and funding changes.
Ensure timely and accurate billing and financial reimbursement. Analyze trends, troubleshoot issues, and maximize revenue.
Collaborate with EHR and Analytics team on technical changes, procedure updates, and reporting requirements due to regulatory or payer changes.
Work with the Chief Financial Officer to review monthly financial statements and prepare monthly Accounts Receivable reports for the Finance Committee.
Perform additional duties as assigned.
Billing, Coding & Claims Management
Oversee accurate and timely preparation, review, and submission of claims to commercial, Mass Health, and other payers.
Personally prepare and submit claims during high‑volume periods, staff absences, or vacancies.
Ensure coding for behavioral health services, including individual and group therapy, psychiatric evaluations, medication management, case management, and telehealth.
Identify and correct coding or documentation issues in collaboration with clinical teams.
Maintain expertise in behavioral health billing nuances, including no‑shows, authorization‑driven services, and payer‑specific requirements.
Contracts & Payer Management
Manage payer contracts, including fee schedules, authorization requirements, and billing rules.
Serve as the primary point of contact with insurance companies regarding billing, payment, and contract‑related inquiries.
Monitor payer performance and elevate issues related to underpayments, delays, or systemic denials.
Payment Posting, Reconciliation & Accounts Receivable
Ensure accurate posting and reconciliation of insurance and patient payments.
Monitor accounts receivable aging and lead systematic follow‑up on unpaid claims.
Investigate and resolve payment discrepancies, underpayments, and zero‑pay claims.
Coordinate patient billing, statements, and collections for deductibles, co‑pays, and outstanding balances.
Denial Management & Appeals
Review and analyze denied claims and determine appropriate corrective actions.
Prepare, submit, and track appeals, especially those related to medical necessity, authorization limits, and documentation requirements.
Identify denial trends and collaborate with clinical and administrative teams to monitor recurrence.
Compliance & Regulatory Oversight
Ensure billing and contracting practices comply with federal, state, and payer regulations.
Act as the Walker contact on behavioral health billing rules and regulatory changes.
Support internal and external audits and maintain required documentation.
Train and support billing staff to ensure consistent performance and compliance.
Establish efficient workflows and internal controls across billing and contracts functions.
Conduct performance reviews and provide coaching and professional development.
Financial Reporting & Analysis
Monitor and report key revenue cycle metrics, including collection rates, days in A/R, denial rates, and payer trends.
Provide regular reporting and insights to senior leadership and the finance team.
Support revenue forecasting and cash flow planning related to behavioral health services.
Systems & Process Improvement
Oversee billing systems and EHR functionality related to claims, payments, and reporting.
Coordinate system updates and troubleshoot issues in partnership with IT.
Train staff on new system features, payer changes, and process improvements.
Required Education and Experience
Bachelor’s degree in healthcare administration, finance, business, or a related field (or equivalent experience).
Minimum of 5 years of experience in behavioral health billing and revenue cycle management.
Demonstrated knowledge of mental health billing codes (ICD‑10, CPT, HCPCS) and payer requirements.
Experience managing denials, appeals, and payer communications.
Strong understanding of healthcare compliance and regulatory requirements.
Preferred
Supervisory or management experience in a billing or revenue cycle function.
Experience managing payer contracts and fee schedules.
Experience with behavioral health EHR and billing systems.
Skills & Competencies
Strong attention to detail and analytical skills.
Ability to manage multiple priorities and deadlines.
Clear and professional communication with staff, payers, clinicians, and patients.
Collaborative, solutions‑oriented leadership style.
Commitment to accuracy, compliance, and continuous improvement.
Supervision Reporting to: Chief Financial Officer. Supervises: Billing Staff and Consultants.
Location Boston, MA
#J-18808-Ljbffr
is responsible for overseeing all aspects of behavioral health billing, payer contract administration, and revenue cycle performance. This role ensures accurate and compliant billing, timely collections, effective denial management, and strong payer relationships while supervising billing staff and partnering closely with clinical, administrative, and finance teams. The ideal candidate brings extensive knowledge of mental health billing regulations, payer requirements, and revenue cycle best practices.
Education Required: Bachelor’s degree in accounting, business, or related field of study.
Experience Required: A minimum of seven years accounting, billing, and contracting experience, including third‑party billing for behavioral health services. Experience with clearinghouses and electronic payment systems. Proficient with Microsoft Office, especially Excel.
Abilities Required: Ability to meet deadlines and follow through with multiple projects simultaneously. Excellent verbal and written communication skills.
Essential Functions
Lead billing and accounts receivable staff, ensuring accurate billing in accordance with the monthly closing schedule and diligent follow‑up on collections.
Maintain billing and collection procedures and support billing staff during volume peaks or absences.
Prepare contracts that support program goals, budgets, and the Agency’s Strategic Plan.
Maintain a contract list including general ledger and UFR mapping.
Update and negotiate annual rates and maintain dialogue with key state agency and third‑party insurance officials regarding new initiatives and funding changes.
Ensure timely and accurate billing and financial reimbursement. Analyze trends, troubleshoot issues, and maximize revenue.
Collaborate with EHR and Analytics team on technical changes, procedure updates, and reporting requirements due to regulatory or payer changes.
Work with the Chief Financial Officer to review monthly financial statements and prepare monthly Accounts Receivable reports for the Finance Committee.
Perform additional duties as assigned.
Billing, Coding & Claims Management
Oversee accurate and timely preparation, review, and submission of claims to commercial, Mass Health, and other payers.
Personally prepare and submit claims during high‑volume periods, staff absences, or vacancies.
Ensure coding for behavioral health services, including individual and group therapy, psychiatric evaluations, medication management, case management, and telehealth.
Identify and correct coding or documentation issues in collaboration with clinical teams.
Maintain expertise in behavioral health billing nuances, including no‑shows, authorization‑driven services, and payer‑specific requirements.
Contracts & Payer Management
Manage payer contracts, including fee schedules, authorization requirements, and billing rules.
Serve as the primary point of contact with insurance companies regarding billing, payment, and contract‑related inquiries.
Monitor payer performance and elevate issues related to underpayments, delays, or systemic denials.
Payment Posting, Reconciliation & Accounts Receivable
Ensure accurate posting and reconciliation of insurance and patient payments.
Monitor accounts receivable aging and lead systematic follow‑up on unpaid claims.
Investigate and resolve payment discrepancies, underpayments, and zero‑pay claims.
Coordinate patient billing, statements, and collections for deductibles, co‑pays, and outstanding balances.
Denial Management & Appeals
Review and analyze denied claims and determine appropriate corrective actions.
Prepare, submit, and track appeals, especially those related to medical necessity, authorization limits, and documentation requirements.
Identify denial trends and collaborate with clinical and administrative teams to monitor recurrence.
Compliance & Regulatory Oversight
Ensure billing and contracting practices comply with federal, state, and payer regulations.
Act as the Walker contact on behavioral health billing rules and regulatory changes.
Support internal and external audits and maintain required documentation.
Train and support billing staff to ensure consistent performance and compliance.
Establish efficient workflows and internal controls across billing and contracts functions.
Conduct performance reviews and provide coaching and professional development.
Financial Reporting & Analysis
Monitor and report key revenue cycle metrics, including collection rates, days in A/R, denial rates, and payer trends.
Provide regular reporting and insights to senior leadership and the finance team.
Support revenue forecasting and cash flow planning related to behavioral health services.
Systems & Process Improvement
Oversee billing systems and EHR functionality related to claims, payments, and reporting.
Coordinate system updates and troubleshoot issues in partnership with IT.
Train staff on new system features, payer changes, and process improvements.
Required Education and Experience
Bachelor’s degree in healthcare administration, finance, business, or a related field (or equivalent experience).
Minimum of 5 years of experience in behavioral health billing and revenue cycle management.
Demonstrated knowledge of mental health billing codes (ICD‑10, CPT, HCPCS) and payer requirements.
Experience managing denials, appeals, and payer communications.
Strong understanding of healthcare compliance and regulatory requirements.
Preferred
Supervisory or management experience in a billing or revenue cycle function.
Experience managing payer contracts and fee schedules.
Experience with behavioral health EHR and billing systems.
Skills & Competencies
Strong attention to detail and analytical skills.
Ability to manage multiple priorities and deadlines.
Clear and professional communication with staff, payers, clinicians, and patients.
Collaborative, solutions‑oriented leadership style.
Commitment to accuracy, compliance, and continuous improvement.
Supervision Reporting to: Chief Financial Officer. Supervises: Billing Staff and Consultants.
Location Boston, MA
#J-18808-Ljbffr