Insurance Billing Manager

HopeSparks Family Services • Tacoma, WA

5d • $72,000 - $90,000 • Onsite

About The Position

The HopeSparks Insurance Billing Manager is accountable for the integrity, accuracy, and compliance of insurance billing and provider credentialing functions supporting HopeSparks' remaining fee-for-service programs, with primary responsibility for the Children's Developmental Services (CDS)program. This role provides operational leadership and subject-matter expertise in insurance billing, payer compliance, and provider credentialing, ensuring billing practices support timely reimbursement, regulatory compliance, and sound financial stewardship. The Billing Manager exercises independent judgment in managing billing operations, supervising staff, maintaining credentialing readiness, identifying compliance risks, and recommending process improvements. The position serves as the primary operational resource to the CFO on insurance billing and credentialing matters. HopeSparks believes that a diverse workforce and inclusive workplace culture enhance our ability to fulfill our mission. We strive for equity and justice in the way people are treated and the opportunities they have to succeed by working to address racism, inequitable treatment, and other barriers to inclusion. We strongly encourage candidates from diverse backgrounds (including communities of color, the LGBTQIA+ community, veterans, and people with disabilities) to apply and join us in our work. Please see our Commitment to Diversity, Equity, and Inclusion on our website.

Requirements

• Associate's or Bachelor's degree in healthcare administration, business, finance, or a related field, or equivalent experience.
• Minimum of 3–5 years of progressive experience in medical insurance billing, including claims submission, payment posting, denial management, and appeals.
• Demonstrated working knowledge of provider credentialing processes and payer compliance requirements.
• Experience with Medicaid and commercial insurance billing; behavioral health and early intervention/ESIT experience preferred.
• Ability to interpret and apply insurance contracts, fee schedules, and payer-specific billing rules.
• Experience using electronic health record (EHR) and billing systems.
• Strong attention to detail, analytical skills, and ability to manage multiple priorities and deadlines.
• Effective written and verbal communication skills, including professional interaction with payers, external and internal partners.
• Ability to work independently while contributing to a collaborative, team-based environment.
• Commitment to HopeSparks' mission and values, including family-centered, equitable, and culturally responsive services.
• Must successfully pass required state and federal background checks.

Responsibilities

• Billing Operations & Compliance Direct and oversee insurance billing operations, establishing priorities, controls, and standards to ensure compliant and timely reimbursement.
• Ensure accurate and timely claims submission, payment posting, denial management, appeals, and reconciliation activities.
• Serve as the primary point of accountability for billing compliance with Medicaid, TriCare, and applicable commercial insurance requirements.
• Interpret and apply payer contracts, funding agreements, and internal billing policies to ensure operational compliance.
• Proactively identify billing risks, compliance gaps, and reimbursement vulnerabilities and implement corrective actions.
• Coordinate with the EHR Administrator to ensure billing workflows, system configurations, and data integrity support compliant billing practices.
• Resolve complex client and payer billing issues requiring escalation.
• Maintain integrity and compliance across all billing and collection-related processes.
• Supervision & Leadership Provide direct supervision, evaluation, and performance management, ensuring accountability to role expectations and partnering with HR to address performance concerns as needed.
• Accountable for the quality, timeliness, and compliance of billing work performed by direct report.
• Set priorities, assign work, and exercise discretion in managing workloads to meet organizational cash-flow and compliance needs.
• Identify training needs and ensure the billing team remains current on insurance regulations, payer requirements, and internal procedures. Cross-training is expected.
• Implement corrective action plans and process improvements as needed to meet performance expectations.
• Demonstrate collaborative, trauma-informed, equitable, and inclusive leadership behaviors consistent with HopeSparks' values.
• Communicate clearly and professionally with team members and internal partners.
• Credentialing Oversight Own and manage provider credentialing and re-credentialing processes required to support CDS and other billable services.
• Ensure continuous credentialing readiness and prevent billing disruptions due to lapsed or incomplete credentialing
• Maintain accurate, up-to-date provider credentialing records, including CAQH, OneHealthPort, and payer-specific requirements.
• Ensure credentialing information is accurately reflected in the EHR and payer systems.
• Monitor regulatory and payer changes impacting credentialing requirements and operational eligibility.
• Serve as the internal subject-matter expert on provider credentialing requirements and their implications for billing and reimbursement.
• Communicate credentialing status changes and risks to appropriate internal stakeholders.
• Insurance Contract Maintenance Maintain insurance contract documentation and required payer records.
• Interpret insurance contract terms, fee schedules, and billing requirements, and ensure accurate operational application.
• Assess billing, reimbursement, and credentialing impacts of contract terms and proposed changes.
• Effectively communicate changes to appropriate parties.
• Serve as the administrative liaison with insurance payers regarding billing, credentialing, and contract compliance matters.
• Maintain required payer data files and shared documentation.
• Provide operational analysis, billing impact assessments, and subject-matter consultation to leadership regarding insurance contract negotiations and payer expansion considerations, as requested.
• Reporting & Performance Monitoring Track, analyze, and report key billing performance indicators to the CFO.
• Identify trends, operational issues, and opportunities for process improvement.
• Prepare documentation and coordinate responses for internal and external audits, payer reviews, and compliance inquiries.
• Support continuous improvement of billing, credentialing, and compliance practices.

Benefits

• HopeSparks offers full benefits to all team members working 30 or more hours per week. Benefits include medical, dental, vision, Life, Long Term Disability, 403b retirement, 9 paid holidays and generous PTO accrual.
• Mentorship, interdisciplinary collaboration, professional development opportunities, closure weeks (additional time off), flexible hours/schedule, continuing education funds available.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree