Revenue Cycle Billing Manager

SUMMARY OF POSITION
The Revenue Cycle Billing Manager is responsible for the management and oversight of behavioral health revenue cycle operations, including billing, claims processing, reimbursement management, denial resolution, collections, and revenue integrity activities. The position ensures the accurate, timely, and compliant submission, adjudication, and reconciliation of claims across multiple behavioral health service lines and funding sources.

Under the direction of the Chief Financial Officer (CFO), the Revenue Cycle Billing Manager provides leadership for revenue cycle staff, develops and monitors billing processes and performance metrics, and ensures compliance with applicable regulatory, contractual, payer, and organizational requirements. The position serves as a key operational partner to Finance, Clinical Operations, Quality Assurance, Information Systems, and external payers to support reimbursement optimization, audit readiness, and overall financial performance.

ESSENTIALS DUTIES

• Lead all revenue cycle operations for behavioral health programs, including Acute Psychiatric Inpatient, Residential Treatment, Outpatient Mental Health, Crisis Services, and County- and State-funded programs, ensuring timely, accurate billing, claims submission, payment posting, reconciliation, and collections.
• Oversee the full claims management process, including denial prevention, claim resolution, reimbursement optimization, underpayment recovery, eligibility verification, authorizations, and payer follow-up. Serve as the primary liaison with Los Angeles County Department of Mental Health (LACDMH), Medi-Cal, SAPC, managed care organizations, commercial payers, and other funding sources.
• Ensure revenue integrity and regulatory compliance by maintaining adherence to payer requirements, government regulations, contractual obligations, documentation standards, and organizational policies. Partner with Clinical Operations and Quality Assurance to address documentation issues, improve billable service capture, and support audits, reviews, and monitoring activities.
• Analyze billing, reimbursement, denial, and collection trends; develop key performance indicators (KPIs); prepare operational and financial reports; identify revenue enhancement opportunities; and implement process improvements that strengthen revenue cycle performance and cash flow.
• Supervise and develop billing and revenue cycle staff, establish productivity and quality standards, provide training on reimbursement regulations and workflow processes.
• Collaborate with Finance, Operations, Quality, and HIS teams on system implementations, workflow redesign, and revenue cycle optimization initiatives.
• Serve as the organizational subject matter expert on behavioral health reimbursement and revenue cycle operations.

ESSENTIAL SKILLS

• Proven leadership and staff management skills, including team development, coaching, performance management, workforce planning, and establishment of productivity and quality standards.
• Demonstrated ability to analyze financial, operational, and reimbursement data, develop key performance indicators (KPIs), identify trends, and implement strategies that improve cash flow, collections, and overall revenue cycle performance.
• Exceptional problem-solving and critical-thinking abilities, with a demonstrated track record of resolving complex billing, reimbursement, payer, and operational challenges.
• Strong project management and process improvement capabilities, including workflow redesign, system implementations, revenue cycle optimization initiatives, and change management.
• Effective relationship management and collaboration skills, with the ability to partner successfully with finance, clinical, quality, operations, information systems teams, government agencies, managed care organizations, and commercial payers.
• Proficiency with behavioral health electronic health record (EHR) systems, billing platforms, reporting tools, and Microsoft Office applications, particularly Excel for financial analysis and reporting.
• Excellent written, verbal, and presentation communication skills, with the ability to effectively communicate complex reimbursement, operational, and financial information to frontline staff, organizational leadership, and external stakeholders.

EXPERIENCE/QUALIFICATIONS

• Minimum of 7–10 years of progressively responsible healthcare revenue cycle and behavioral health billing experience, including significant experience with LACDMH-funded programs and Medi-Cal reimbursement.
• Minimum of 3–5 years of leadership or supervisory experience in healthcare billing, reimbursement, or revenue cycle operations.
• Strong knowledge of:
  • Los Angeles County Department of Mental Health (LACDMH) billing requirements
  • Medi-Cal reimbursement methodologies
  • Eligibility verification and authorization processes
  • Behavioral health documentation standards
  • Revenue cycle performance improvement
• Experience with SAPC billing, Substance Use Disorder (SUD) reimbursement programs, managed care organizations, and commercial payer billing is highly preferred.

EDUCATION/CERTIFICATES

• Bachelor's degree in Healthcare Administration, Business Administration, Accounting, Finance, Public Health, or a related field preferred.
• Equivalent combinations of education, professional certifications, and progressively responsible behavioral health revenue cycle experience will be considered.
• Relevant certifications such as Certified Revenue Cycle Representative (CRCR), Certified Professional Biller (CPB), Certified Healthcare Financial Professional (CHFP), or similar credentials are highly desirable.

REQUIREMENTS

• Must pass Department of Justice (DOJ), Federal Bureau of Investigations (FBI), and Community Care Licensing (CCL) background clearance.
• Valid California Driver’s license.
• TB clearance.
• Driving record acceptable for coverage by Gateways insurance carrier

Gateways believes that our people are our greatest asset and is proud to offer competitive benefits that support their health, happiness and career development. 

• Cover 100% Medical/Dental/Vision Premiums for all Full-Time Employees and 1 Dependent 
• 8 Paid Holidays + 4 Personal Holidays in Calendar Year
• 2 Weeks of Vacation
• 403b Retirement Plan Company Match 8%
• Annual Company Events