Billing Manager

Fora Health Inc•Portland, OR

just now•$90,000 - $110,000•Hybrid

About The Position

The Billing Manager is a key leadership role within the Finance department, responsible for the full lifecycle of revenue operations at Fora Health. This position oversees the Billing/Authorization team, ensuring that claims are accurately coded, submitted, and collected in a timely manner, and that all contracts and grants are properly administered, invoiced, and reported. Reporting to the Director of Finance and Accounting, the Billing Manager serves as the organization's subject matter expert on payer regulations, billing compliance, and revenue optimization. This role is responsible for translating complex Oregon Health Plan, Medicaid, and commercial payer requirements into efficient operational workflows. This role plays a critical part in sustaining Fora Health's financial health so that the organization can continue delivering accessible, high-quality substance use disorder treatment to the communities it serves. The Billing Manager leads a team of billing professionals, fostering a culture of accuracy, accountability, and continuous learning. This position partners closely with clinical and operational leadership to resolve billing issues, reduce denials, and identify opportunities to maximize reimbursement while ensuring all practices remain fully compliant with Federal, State, and payer-specific requirements.

Requirements

Bachelor’s degree and/or five years commensurate experience with a minimum of two years of supervisor/manager experience within the revenue cycle function in the behavioral health industry.
Experience with Oregon Health Plan (OHP)/Medicaid and Medicare billing
Experience with behavioral health billing codes
Experience with an EHR (e.g., Credible, Netsmart, Epic, eClinicalWorks, etc.)
Clearinghouse experience (Waystar, Availity, etc.)
Familiarity with payor portals
Ability to interpret and apply state-specific payor guidelines and regulations
Ability to lead collaborations in a cross-team environment
Ability to recognize patterns
Comfortable creating solutions when ambiguity exists
Professional demeanor, excellent communication, and interpersonal skills
Initiative and problem-solving skills including creativity, resourcefulness and timeliness
Ability to organize time, set priorities and meet deadlines of conflicting demands
Strong capability of working both independently and as a member of a collaborative team
Excellent written and verbal communication skills.
Knowledge of areas related to agency licensing and operations
Demonstrates flexibility regarding job duties and assignments
Proficient in Microsoft Office Suite, specifically Outlook, Excel and Word
Ability to maintain professional boundaries with patients, the community, and other staff members.
Displays initiative and problem-solving skills
Basic knowledge of substance-use disorders
Marked ability to demonstrate and utilize self-awareness
For employees with a history of substance use disorder, Fora Health’s policy requires certification of a minimum of six months of sobriety for this position.
Ability to pass a pre-employment or for cause drug tests.
Ability to pass DHS criminal background
Position will require some amount of regular connection to work via cell phone to answer questions and respond to internal and external contacts.

Responsibilities

Serve as the go-to expert for all coding and billing processes, guiding your team to achieve peak performance.
Oversee the entire billing cycle, from patient insurance to collections, ensuring accuracy and efficiency at every step.
Research and translate complex and ambiguous state-level and payor-specific rules into actionable system logic.
Stay ahead of industry changes, ensuring our operations align with Federal, State, and payer regulations.
Monitor and analyze billing trends, adjust staff and procedures to maximize efficiency and revenue.
Perform root-cause analysis to identify denials patterns and work to resolve payor or internal issues.
Audit current procedures and implement new strategies to enhance the efficiency of our billing and collections operations.
Supervise, train, and motivate your team, fostering a culture of excellence and continuous growth.
Collaborate effectively with clinical staff and other departments to streamline coding procedures, resolve any issues promptly, facilitate smooth billing processes.
Create and monitor Key Performance Indicators (e.g., net collection rate, days in AR, clean claim rate, denial rates, etc.).
Manage and track payor contracts to ensure up to date compliance of Fora billing practices and work with internal leadership and payors as needed to negotiate rates.
Update EHR and billing with rate changes ensuring accurate reporting of anticipated revenue.
Oversee staff credentialing ensuring up-to-date State and payor credentials.
Work with HR and hiring managers to on-board new staff to efficiently and effectively credential new providers.
Attend staff meetings as scheduled.
Additional trainings to be completed as assigned in a timely manner.
Special projects and other duties as assigned.
Participate in ongoing supervision and consultation.
Provide leadership to the teams in such a way that the work environment supports and encourages values of the agency: honesty, empathy, respect, inclusion, unity.