Billing and Credentialing Manager

McCall Behavioral Health Network•Waterbury, CT

4d•Hybrid

About The Position

Provides coordination, administration, and evaluation of McCall’s billing, collection, and credentialing functions. This is a full-time, in-office position. Salary range begins at $85,000. Schedule is Monday to Friday, with time worked in both the Waterbury, CT, and Torrington, CT offices.

Requirements

A bachelor’s degree or equivalent education, training, and experience, plus a minimum of 4-5 years of closely related experience.
Knowledge of and experience with health and behavioral health insurance requirements.
Experience and expertise in medical billing and coding.
Considerable knowledge of the principles and practices of public and/or health care administration.
The ability to define problems, collect data, establish facts, and draw conclusions.
Able to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with abstract and concrete variables.
Ability to read, analyze, and interpret complex documents.
Able to effectively present information to agency staff and senior leadership.
Ability to work with mathematical concepts such as probability and statistical inference.
Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Initiative
Leadership
Team-Player
Time Management
Decision Making
Communication Proficiency (Verbal & Written)
Technology & Computer Literacy (Microsoft Office, Keyboarding)
Prolonged periods of time sitting at a desk, using the phone, and working on a computer.
Must be able to lift up to 20 pounds at times.
A valid driver’s license is required.

Responsibilities

Supervises billing and collection staff within the Finance Department, oversees and coordinates all billing and collection functions across the organization.
Defines billing and collection reporting needs.
Works closely with relevant program leadership to coordinate billing and collection processes, insurance verification, coding for medical and behavioral health bills, collection of co-pays, self-pays, and other fees, and the resolution of any denials, collections, and insurance issues. Serves as primary contact for external payors: responds to inquiries, facilitates issue resolution including appeals, participates in contract discussions, etc.
Coordinates with front-desk/intake staff to ensure timeliness and accuracy of patient processing; ensures patient information is organized and complete.
Supervision responsibilities include input on hiring and termination decisions, training staff, distributing and monitoring workloads, oversight of credentialing, solving workflow issues, conducting performance management activities, completing performance evaluations, and ensuring appropriate staffing.
Creates and maintains all fee schedules and sliding scale.
Acts as a super-user for the electronic health record (EHR); recommends computer system and business process enhancements; ensures that IT is utilized fully to capture the necessary billing and collection documentation.
Utilizes data from EHR system to audit clinician entries and analyze metrics and trends, in order to develop recommendations for best practices.
Responsible for monitoring insurance regulations and implementing applicable updates within the organization.
Participates in quality assurance and improvement teams as appropriate.
Facilitates regular staff meetings as well as individual supervision with all staff.
Participates in Finance Department team meetings and accurately relays information to staff.
Performs other duties as assigned