Billing and Reimbursement Manager

The Billing and Reimbursement Manager represents the core values and mission of the organization and manages day-to-day processes for billing through third party payors and Medicaid to ensure all avenues of billing are maximized. The Manager provides leadership and accountability for maximizing reimbursement across Medicaid, Medicare, commercial insurance, Recovery Works, and SOR funding, while ensuring compliance with regulatory and payer requirements. This role manages and performs reimbursement operations, billing, collections, accounts receivable, credentialing, payer enrollment, prior authorization submissions, denial and claim management, and revenue integrity initiatives.

Essential duties and responsibilities include:

• Submit and manage billing with various vendors (including but not limited to private insurance, Medicaid, Recovery Works, SOR) on a weekly basis, working with leadership to maximize revenue for the agency.
• Develop and maintain working relationships with billing vendors to maximize revenue.
• Direct revenue cycle operations and billing functions from registration through final payment.
• Ensure accurate, timely, and compliant claim submission while continuously improving clean claim rates and first-pass payment resolution.
• Monitor ageing reports and develop and implement recovery plans for outstanding balances.
• Improve cash collections and revenue cycle efficiency for billing/claims.