Postgraduate Center for Mental Health · 10 hours ago
Insurance and Billing Operations Manager
New York, NY
Full-time
Onsite
Senior Level
5+ years expPostgraduate Center for Mental Health is seeking an Insurance and Billing Operations Manager to oversee insurance, billing, and eligibility functions across two mental health clinics. The role involves ensuring timely access to services, accurate billing, and effective resolution of insurance inquiries and disputes while collaborating with clinical teams and administrative leadership.
Health CareHealth DiagnosticsMental HealthNursing and Residential Care
Responsibilities
Oversee the daily verification of insurance eligibility for new and returning clients
Ensure authorizations, referrals, and required documentation are obtained prior to service
Monitor ongoing eligibility changes and communicate updates to clinical and administrative teams
Resolve complex eligibility issues, including lapses, denials, and changes in coverage
Manage the billing workflow for two mental health clinics, ensuring accurate and timely claim submission
Monitor claim status, address rejections, and work closely with billing partners to resolve denials
Conduct routine audits of billing accuracy, CPT coding alignment, and documentation compliance
Track and report on revenue cycle KPIs (e.g., days in A/R, denial rate, clean claim rate)
Serve as point person for escalated billing and insurance disputes from clients, staff, and insurance carriers
Collaborate with insurance representatives to resolve reimbursement discrepancies or claim issues
Maintain clear documentation of communications, appeals, and dispute resolutions
Partner with clinic leadership to ensure staff are following required insurance and billing procedures
Train front-desk, intake, and clinical staff on eligibility workflows, documentation standards, and billing expectations
Provide recommendations for process improvements to increase efficiency and reduce revenue loss
Ensure compliance with federal, state, and payer regulations, including HIPAA, OMH/DOHMH requirements, and insurer guidelines
Keep leadership informed of insurance policy updates impacting billing or eligibility
Develop and maintain SOPs for eligibility checks, billing escalations, and dispute resolution
Build and maintain strong working relationships with insurance carriers and provider networks
Serve as the primary contact for payer representatives regarding clinic billing, claims, credentialing, and operational needs
Support negotiation, renewal, and implementation of insurance contracts, fee schedules, and authorization requirements
Monitor contract performance and identify opportunities to expand payer participation and improve reimbursement rates
Attend payer meetings, webinars, policy updates, and networking sessions to stay informed of changes impacting behavioral health services
Collaborate with leadership to ensure compliance with payer standards, credentialing requirements, and regulatory updates
Qualification
Required
Bachelor's degree in Business, Healthcare Administration, Finance, or related field
Minimum 5 years of experience in healthcare billing, insurance eligibility, or revenue cycle management
Strong knowledge of commercial plans, Medicaid, Medicare, and managed care
Experience working with EHR and billing platforms
Excellent communication, analytical, and problem-solving skills
Ability to work independently, manage competing priorities, and support multiple clinic sites
Preferred
Master's degree in Business, Healthcare Administration, Finance, or related field
Experience in behavioral health
Company
Postgraduate Center for Mental Health
Postgraduate Center for Mental Health helps in housing, health treatment, and case management services for mentally ill patients.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Daler Amonov
Chief Financial Officer
Company data provided by crunchbase