Billing and Revenue Manager
Chicago, IL
Category: Healthcare
Reference ID: 10077991
Shortcut: http://addisongroup.gosnaphop.com/qFG6ij
Job Title: Billing & Revenue Cycle Manager
Industry: Healthcare / Behavioral Health
Location (city, state): Chicago, IL – South Side / Multiple Locations
Assignment Type: Contract-to-Hire Preferred; Direct Hire Considered
Pay: $85,000–$100,000 per year
Work Schedule: Full-time; candidates may work either 8:00 AM–4:00 PM or 9:00 AM–5:00 PM
Benefits: This position is eligible for medical, dental, vision, and 401(k).
About The Company:
Our client is a well-established healthcare and human services organization focused on providing behavioral health and community-based services to diverse populations. The organization promotes collaboration, transparency, professional development, and meaningful community impact.
Job Description:
Our client is seeking an experienced Billing & Revenue Cycle Manager to oversee the full revenue cycle for outpatient behavioral health services. This is a hands-on leadership role responsible for managing a team while remaining actively involved in billing operations, payer relationships, claims, denials, reimbursement, reporting, and process improvement.
The ideal candidate will have strong expertise in Illinois Medicaid, Medicaid MCOs, commercial insurance, and behavioral health billing. This individual will also help guide the organization's expansion into commercial insurance and serve as a key resource for interpreting complex payer requirements and resolving billing challenges.
Key Responsibilities:
- Oversee end-to-end behavioral health revenue cycle activities, including claims, AR, denials, payments, reconciliations, and reporting.
- Lead, mentor, and develop a team of approximately four revenue cycle professionals.
- Remain hands-on with daily billing operations and provide guidance on complex account and claim issues.
- Review rejected, denied, underpaid, and unpaid claims and determine appropriate resolution strategies.
- Interpret Illinois Medicaid, MCO, and commercial payer requirements to ensure accurate billing and reimbursement.
- Support commercial insurance billing initiatives as the organization expands its payer relationships.
- Ensure behavioral health services are billed appropriately using CPT/HCPCS codes, modifiers, authorizations, and applicable payer guidelines.
- Monitor accounts receivable and identify unbilled, underpaid, or incorrectly reimbursed services.
- Compare reimbursement against applicable fee schedules and payer contracts.
- Analyze revenue cycle performance and implement improvements to billing and collection processes.
- Manage and troubleshoot EDI transactions, including 837P, 835, and 999 transactions.
- Support provider enrollment, credentialing, recredentialing, roster updates, and MCO setup.
- Address authorization and prior authorization-related billing issues.
- Monitor updates from Illinois HFS and managed care organizations that impact behavioral health reimbursement.
- Develop revenue cycle reports, dashboards, and performance metrics.
- Partner with clinical, finance, EHR, billing, and payer teams to improve processes and resolve issues.
- Train staff on billing procedures, payer requirements, and revenue cycle best practices.
- Provide revenue cycle updates and recommendations to senior leadership.
Qualifications:
- Bachelor's degree in Finance, Accounting, Healthcare Administration, or a related field required.
- 5+ years of healthcare billing, revenue cycle, healthcare finance, or related experience.
- 1–3+ years of supervisory or management experience.
- Strong hands-on experience with outpatient mental health or behavioral health revenue cycle operations.
- Advanced knowledge of Illinois Medicaid/HFS and Medicaid MCO billing requirements.
- Experience with both Medicaid/MCO and commercial or private insurance billing.
- Strong understanding of behavioral health billing, coding, reimbursement, authorizations, and payer requirements.
- Ability to research and interpret complex payer policies and identify appropriate billing solutions.
- Experience with claims analysis, denials management, AR, payment reconciliation, and reimbursement issues.
- Knowledge of CPT/HCPCS codes, modifiers, fee schedules, and payer contracts.
- Experience with EDI transactions such as 837P, 835, and 999.
- Familiarity with provider enrollment, credentialing, roster management, or MCO setup preferred.
- Strong analytical, communication, leadership, and problem-solving skills.
Additional Details:
- This is a hands-on management position overseeing a team of approximately four employees.
- Collaboration with clinical, finance, program management, EHR, and payer teams is required.
- The position supports multiple behavioral health locations throughout Chicago's South Side.
- Some onsite presence and travel between locations may be required during onboarding.
- Potential for increased flexibility or hybrid work after the initial onboarding period.
- Business-casual professional environment.
- Experience with myEvolv/Netsmart is highly preferred.
- Familiarity with Illinois HFS behavioral health resources, MCO billing manuals, provider notices, and applicable behavioral health fee schedules is strongly preferred.
Perks:
- High-impact leadership opportunity within behavioral health.
- Significant ownership of the organization's revenue cycle operations.
- Opportunity to improve billing, reimbursement, and collection processes.
- Exposure to senior leadership and cross-functional teams.
- Opportunity to lead and develop a revenue cycle team.
- Potential for hybrid flexibility following onboarding.
- Paid holidays, vacation, and sick time.
- 403(b) retirement plan.
- Life insurance and short- and long-term disability coverage.
- Employee assistance program.
- Tuition reimbursement.
- Family medical leave.
Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.
#HC2
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