Walker Therapeutic & Educational Programs ยท 3 hours ago
Billing and Contracts Manager
Needham, MA
Full-time
Onsite
Senior Level
5+ years expWalker Therapeutic & Educational Programs is seeking a Billing and Contracts Manager to oversee all aspects of behavioral health billing and revenue cycle performance. This role is responsible for ensuring accurate billing, timely collections, and managing payer relationships while supervising the billing staff.
EducationHealth CareNon ProfitSpecial EducationTherapeutics
Responsibilities
Responsible for the billing and accounts receivable staff, emphasizing accurate and timely billing in accordance with the monthly closing schedule and follow-up through the collection process. Serve as billing function backup as needed to cover volume of claims and staff absences
Responsible for diligent collection efforts of all accounts receivable
Responsible for establishing and implementation of billing and collection procedures for the accounts receivable function
Prepare contracts that support program goals, budgets, and the Strategic Plan of the Agency
Maintain 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
Responsible for ensuring timely and accurate billing and financial reimbursement. Responsible for analyzing trends and following up with appropriate internal and external stakeholders to troubleshoot issues and maximizing revenue and financial reimbursement
Collaborate with EHR and Analytics team to ensure the timely implementation of technical changes, updates to procedures, and reporting requirements in response to legal, regulatory, and payer changes
Work with the Chief Financial Officer to review monthly financial statements. Prepare monthly Accounts Receivable reports for the Finance Committee
Perform other 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 as needed during high-volume periods, staff absences, or vacancies
Ensure codes 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 escalate 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, particularly those related to medical necessity, authorization limits, and documentation requirements
Identify denial trends and work with clinical and administrative teams to track and monitor recurrence
Ensure billing and contracting practices comply with federal, state, and payer regulations
Serve as the Walker contact on behavioral health billing rules and regulatory changes
Support internal and external audits and maintain required documentation
Advise, train, and support billing staff to ensure consistent performance and compliance
Establish efficient workflows and internal controls across billing and contracts functions
Conduct performance reviews and provide coaching and professional development
Monitor and report key revenue cycle metrics, including collection rates, days in A/R, denial rates, and payer trends
Provide regular reporting and insights to senior leadership and the finance team
Support revenue forecasting and cash flow planning related to behavioral health services
Oversee billing systems and EHR functionality related to claims, payments, and reporting
Coordinate system updates and troubleshoot issues in partnership with IT
Train staff on new system features, payer changes, and process improvements
Qualification
Required
Bachelor's degree in accounting, business, or related field of study
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 including Excel
Ability to meet deadlines and follow through with multiple projects simultaneously
Excellent verbal and written communication skills
Bachelor's degree in healthcare administration, finance, business, or a related field (or equivalent experience)
Minimum of 5 years of experience in behavioral health billing and revenue cycle management
Demonstrated knowledge of mental health billing codes (ICD-10, CPT, HCPCS) and payer requirements
Experience managing denials, appeals, and payer communications
Strong understanding of healthcare compliance and regulatory requirements
Preferred
Supervisory or management experience in a billing or revenue cycle function
Experience managing payer contracts and fee schedules
Experience with behavioral health EHR and billing systems
Company
Walker Therapeutic & Educational Programs
Walker is a leading not-for-profit organization providing intensive, highly specialized therapeutic and academic services for exceptionally vulnerable yet resilient children, teens, and families facing complex mental health, emotional, behavioral, and learning challenges.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
G
Gene Takahashi
President & CEO
Company data provided by crunchbase