Work Schedule: Monday-Friday, days | Work Type: Hybrid
The Billing and Cash Applications Manager is responsible for the overall leadership, management, and performance of the Billing, Cash Applications, and Scanning functions within Revenue Cycle Operations. This position ensures the accurate and timely generation of claims, posting of payments, charge entry, reconciliation of cash activity, maintenance of payer enrollments, and compliance with organizational policies and regulatory requirements.
The manager oversees daily operations, supervises staff, develops operational procedures, monitors key performance indicators, and collaborates with Finance, Information Systems, Clinical Operations, and third-party payers to achieve optimal reimbursement, cash flow, operational efficiency, and service excellence.
Specific responsibilities include:
- Billing Operations and Claims Management
- Provides oversight of daily billing activities across all lines of business to ensure claims are generated, reviewed, and submitted accurately and timely.
- Monitors electronic claim transmission processes and resolves issues impacting claim acceptance and adjudication.
- Reviews claim rejections to identify trends, root causes, and opportunities for process improvement.
- Develops and implements corrective actions to reduce preventable denials and rework.
- Collaborates with operational and clinical departments to resolve billing issues and improve reimbursement outcomes.
- Ensures billing processes support timely cash flow, regulatory compliance, and revenue integrity.
- Cash Applications and Reconciliation
- Supervises the accurate posting of insurance payments, patient payments, contractual adjustments, refunds, recoupments, and other payment transactions.
- Oversees daily reconciliation of payment postings, Electronic Remittance Advices (ERAs), bank deposits, and other cash activity.
- Investigates and resolves unapplied cash, posting variances, balancing discrepancies, and reconciliation issues.
- Coordinates resolution efforts with Finance, Information Systems, banking partners, and third-party payers as needed.
- Monitors Cash Applications productivity, accuracy, and turnaround times to ensure departmental standards are achieved.
- Enrollment and Revenue Cycle Support
- Oversees payer enrollment activities for electronic claims submission and electronic remittance advice (ERA) processing.
- Ensures enrollment records remain accurate, current, and operational.
- Coordinates enrollment updates and changes with payers, clearinghouses, and internal stakeholders.
- Supports implementation of new payer relationships, programs, services, and system enhancements affecting billing and reimbursement functions.
- Leadership and Staff Development
- Supervises, coaches, develops, and evaluates Billing, Cash Applications, and Scanning Team staff.
- Establishes clear performance expectations and accountability standards.
- Conducts performance evaluations and provides ongoing feedback and development opportunities.
- Oversees staffing levels, scheduling, and workload distribution to ensure operational needs are met.
- Develops and delivers training programs related to billing, payment posting, payer requirements, system functionality, and department procedures.
- Promotes a culture of collaboration, continuous improvement, and customer service excellence.
- Operational Management and Process Improvement
- Develops, maintains, and updates Standard Operating Procedures (SOPs) to support operational consistency, training, and compliance.
- Evaluates workflows and recommends improvements to increase efficiency, accuracy, and productivity.
- Assists with system implementations, upgrades, testing, and process enhancements.
- Participates in departmental and organizational initiatives aimed at improving revenue cycle performance.
- Compliance and Regulatory Oversight
- Ensures billing and Cash Applications activities comply with organizational policies, payer requirements, HIPAA regulations, and applicable federal and state laws.
- Maintains knowledge of changing reimbursement regulations, payer policies, and revenue cycle best practices.
- Supports internal, external, payer, and regulatory audits.
- Ensures appropriate documentation and records are maintained to support compliance and audit readiness.
- Reporting and Performance Management
- Monitors and analyzes key performance indicators (KPIs)
- Utilizes reporting tools and dashboards to identify trends, operational risks, and improvement opportunities.
- Prepares and presents operational and performance reports for Revenue Cycle Leadership.
- Provides actionable recommendations to improve reimbursement performance, workflow efficiency, and financial outcomes.
- Customer Service and Relationship Management
- Serves as a resource for internal departments regarding billing and payment posting issues.
- Collaborates with payers, clearinghouses, financial institutions, and external vendors to resolve operational concerns.
- Responds to escalated billing, payment, and reconciliation issues requiring management intervention.
- Maintains professional relationships with internal and external stakeholders to support effective revenue cycle operations.
What you'll get from us.
At Sheppard Pratt, you will work alongside a multi-disciplined team led by a bold vision to change lives. We offer:
- A commitment to professional development, including a comprehensive tuition reimbursement program to support ongoing education and licensure and/or certification preparation
- Comprehensive medical, dental and vision benefits for benefit eligible positions
- 403b retirement match
- Generous paid-time-off for benefit eligible positions
- Complimentary Employee Assistance Program (EAP)
- Generous mileage reimbursement program
The pay range for this position is $74,127.04 to $118,346.18 maximum. Pay for this position is determined on a number of factors, including but not limited to, years and level of related experience.
What we need from you.
- Education Required: Associate's degree in Business, Healthcare Administration, or a related field.
- Education Preferred: Bachelor's degree in Business, Healthcare Administration, or related field.
- Years and Type of Experience Required:
- 1-2 years of experience in a lead, senior, or supervisory capacity with responsibility for guiding staff and supporting operational workflows.
- An additional 2-3 years of progressively responsible experience in healthcare billing, collections, or revenue cycle operations may be considered in lieu of an Associate's degree.
- Work requires a working knowledge of medical billing practices and procedures, accounts receivable management, and third-party payer requirements, including the ability to apply billing policies and reimbursement guidelines in the resolution of patient account and payment-related issues.
- Familiarity with behavioral health and/or mental health billing practices is preferred, including an understanding of payer-specific requirements, authorization processes, and reimbursement considerations applicable to behavioral health services.
- Skills and Abilities Required:
- Demonstrated ability to supervise, coordinate, and prioritize the work of staff, ensuring departmental objectives, productivity expectations, and quality standards are met while balancing multiple assignments and competing priorities.
- Demonstrated organizational, analytical, and problem-solving skills, with the ability to identify issues, evaluate information, and implement appropriate solutions while maintaining accuracy and attention to detail in a fast-paced environment.
- Work requires effective written and verbal communication skills and the ability to interact professionally with staff, patients, payers, and other stakeholders regarding billing processes, account status, and collection-related matters.
- Work requires the ability to meet established deadlines, manage fluctuating workloads, and maintain effective operations amidst frequent interruptions and changing business needs.
- Requires proficiency in the use of billing and accounts receivable systems (Athena IDX preferred), as well as Microsoft Office applications, including the ability to utilize technology and reporting tools to support billing operations, monitor account activity, and maintain accurate records.
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