Billing and Contracts Manager

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.

Required:

Bachelor’s degree in accounting, business, or related field of study.

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.

Required:

Ability to meet deadlines and follow through with multiple projects simultaneously. Excellent verbal and written communication skills.

• 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.

• 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.

• 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.

• 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.

• 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.

• 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…