Medical Billing Manager
About the Organization A mission-driven mental health provider serving communities across Central California is seeking an experienced Billing Manager to oversee revenue cycle operations for fee-for-service and private-pay programs. The team prioritizes compassionate care, operational excellence, and regulatory compliance.Position SummaryThe Billing Manager oversees all billing and reimbursement functions, ensuring timely, accurate claims processing; effective denial management; optimized reimbursement; and strict adherence to payer and regulatory requirements. This leader will guide billing teams, refine workflows, monitor KPIs, and act as a key liaison among billing, finance, clinical programs, payers, and clearinghouses.Key Responsibilities*Lead daily operations for fee-for-service and private-pay billing teams: claim preparation, submission, follow-up, denial management, collections (including self-pay), prior authorizations, and electronic claims processing*Ensure accurate, timely submission of claims to government and commercial payers in accordance with payer rules, internal standards, and regulations*Oversee review, correction, and resubmission of denied/rejected claims to maximize reimbursement and reduce AR aging*Track changes in payer policies and billing regulations to ensure ongoing compliance*Provide training, mentorship, and performance management for billing staff; promote a culture of accountability and continuous improvement*Collaborate with billing, program, and finance teams to resolve account discrepancies, outstanding balances, workflow issues, and EHR-related concerns*Audit processes and documentation for accuracy and efficiency; recommend and implement improvements*Prepare and analyze reports on clean claim rates, denial trends, AR aging, write-offs, and other key billing metrics; present insights to leadership*Serve as the primary resource for complex billing inquiries; act as liaison with clearinghouses, payers, and vendors*Support EHR testing, builds, training, and enhancements aligned to revenue cycle best practices*Perform additional duties as needed to support billing operations and organizational goalsRequired QualificationsBachelor's degree in Healthcare Administration, Accounting, or a related field5+ years of recent experience in medical/healthcare/behavioral health or nonprofit billing1-2 years in a supervisory role or equivalent leadership experience in a billing/revenue cycle settingIn-depth knowledge of CPT, ICD-10, HCPCS, and payer requirements for government and commercial insuranceProficiency with EHR platforms (e.g., Epic, Cerner, eClinicalWorks, Credible) and clearinghouse systems (e.g., Availity, Office Ally)Strong Excel skillsClear understanding of HIPAA and regulatory compliance for billing and remittanceAbility to manage complex billing inquiries with staff, payers, and leadershipHow to Apply?Please send your resume to k a r l a m@appleone.com under the subject of \"Medical Billing Manager\"Equal Opportunity Employer / Disabled / Protected VeteransThe Know Your Rights poster is available here:https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdfThe pay transparency policy is available here:https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdfFor temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf