Practice Manager - Start Up Mental Health Practice

Job Description

The Practice Administrator role is critical to ensuring financial sustainability and operational efficiency. Below is a detailed breakdown of the responsibilities and qualifications for this role:

Job Title - Billing and Revenue Cycle Manager

Reports To - Clinical Director or CEO

Employment Type - Full-Time or Contract (depending on clinic size and needs)

Key Responsibilities

1. Insurance Claims Management

- Oversee the submission of insurance claims to ensure accuracy and timeliness.

- Monitor claim rejections, denials, and delays, and implement strategies to resolve issues.

- Ensure compliance with insurance regulations and coding standards (e.g., CPT, ICD-10).

2. Credentialing and Provider Enrollment**

- Maintain organized and up-to-date credentialing files for all clinicians.

- Ensure clinicians are credentialed with major insurance panels and oversee re-credentialing as needed.

- Act as the primary contact for insurance companies regarding credentialing and provider enrollment.

3. Revenue Cycle Management

- Supervise the billing team to ensure accurate and timely invoicing.

- Monitor accounts receivable (A/R) and follow up on unpaid claims.

- Implement strategies to maximize revenue collection and reduce A/R days.

4. Appointment and No-Show Management

- Ensure appointments are tracked and attended, and follow up on missed appointments.

- Oversee the implementation of no-show and late fee policies, including charging credit cards on file.

- Work with the scheduling team to minimize gaps in the schedule and optimize clinician productivity.

5. Financial Reporting and Analysis

- Generate regular reports on billing, collections, and revenue cycle performance.

- Analyze financial data to identify trends, inefficiencies, and opportunities for improvement.

- Present findings to leadership and recommend actionable strategies.

6. Team Supervision and Training

- Train and supervise billing and administrative staff.

- Ensure staff are knowledgeable about insurance policies, billing procedures, and clinic policies.

- Foster a collaborative and efficient work environment.

7. Compliance and Risk Management

- Ensure compliance with HIPAA, insurance regulations, and other legal requirements.

- Implement and monitor internal controls to prevent billing errors and fraud.

- Address patient billing inquiries and resolve disputes in a professional manner.

Qualifications

Education and Experience

- Bachelor’s degree in Healthcare Administration, Business, or a related field (preferred).

- Minimum of 3-5 years of experience in medical billing, revenue cycle management, or practice administration.

- Experience in mental health billing and credentialing is highly desirable.

Skills and Competencies

- Strong knowledge of insurance billing, coding, and credentialing processes.

- Proficiency in practice management software (e.g., SimplePractice, TherapyNotes) and electronic health records (EHR).

- Excellent organizational and leadership skills.

- Ability to analyze financial data and implement process improvements.

- Strong communication and problem-solving skills.

Key Performance Indicators (KPIs)

- Percentage of claims submitted on time and without errors.

- Days in accounts receivable (A/R).

- Collection rate (percentage of billed amounts collected).

- No-show rate and percentage of no-show fees collected.

- Clinician productivity (number of billable hours per clinician).

How This Role Fits into our Practice

This individual will play a critical role in ensuring the financial health of our Practice. By overseeing insurance claims, credentialing, and revenue cycle management, this person will help maximize profits, reduce inefficiencies, and ensure a seamless experience for both clients and clinicians.