Job Description

Job Description

Who We Are:

At Midwest Behavioral Health Center, our mission is to transform lives and inspire wellness through evidence-based care. To provide our patients with the best possible outcomes, we recognize the importance of cultivating a nurturing, dynamic, safe, and inclusive work environment. We strive to be a premier employer of choice as we aspire to set the standard for compassionate care.

Midwest Behavioral Health Center is designed to provide a full continuum of comprehensive inpatient and outpatient behavioral health services to children, adolescents, and adults in need of support in our community.

Who We Are Looking For:

Midwest Behavioral Health Center is seeking a proactive Revenue Cycle Manager with a strong, comprehensive background in revenue cycle management who is passionate for the services we provide.

Position Overview:

The Revenue Cycle Manager is a key member of the MBHC administrative team. They are responsible for the oversight and execution of the entire revenue cycle for a diverse payor mix. They will ensure accurate billing, claims processing, payor relations, and strategic growth planning. The Revenue Cycle Manager will also have a participating role in fostering a positive and collaborative work environment.

Key Responsibilities:

• Critical to understand, fully believe in, and be responsible for conducting MBHC’s mission and vision.
• Oversee the full revenue cycle management process, including patient registration accuracy, insurance verification, charge capture, claim submission, payment posting, denial management, and accounts receivable follow-up.
• Supervise, manage, and mentor the revenue cycle team in accordance to policy and identified need for professional development. This includes but is not limited to: scheduling, supervision, regular performance evaluations, goal setting, constructive feedback, corrective action, performance improvement planning, and individualized support.
• Prepare and submit clean claims to the appropriate payors. This may include state contracts, commercial insurance, Medicaid, Medicare, and out-of-network payors.
• Ensure accuracy and compliance with payor-specific guidelines, coding, and documentation requirements.
• Monitor and follow up on submitted claims to ensure timely payment and resolve any issues related to denials or rejections.
• Analyze revenue cycle management reports and key performance indicators to optimize financial performance and identify trends or issues in billing processes.
• Review and verify patient insurance benefits, collect and process co-pays, monitor deductibles to adjust billing accordingly, and communicate out-of-pocket costs to patients.
• Set up and maintain billing systems and payor profiles within the EMR, practice management systems, and other related platforms.
• Ensure all systems reflect current CPT, ICD-10, HCPCS codes, and payor requirements.
• Support internal audits and external reviews with complete and accurate billing documentation.
• Identify and implement process improvements that enhance billing accuracy, speed, and regulatory compliance.
• Understand, remain informed, implement, and adhere to all current federal, state, accreditor, licensure, payor, or internal policies, procedures, and protocols applicable to billing operations.
• Provide ongoing needed or required training and education to staff, as assigned.
• Support leadership in future planning and initiatives for network and revenue growth.
• Participate in payor contract discussions, negotiations, onboarding, and performance analysis, as assigned.
• Build and maintain effective relationships with payor representatives to resolve issues.
• Ensure identified facility or department metrics and key performance indicators are achieved.

Education and Experience:

• Associate or Bachelor’s degree in Healthcare Administration, Finance, or related field preferred; a high school diploma or equivalent required.
• A minimum of 3 years of experience in medical billing and revenue cycle management is required.
• A minimum of 1 year of experience in behavioral healthcare setting is required.
• A minimum of 1 year of experiencing in a leadership role is required.
• Strong knowledge of commercial insurance, Medicaid (Michigan), Medicare, and out-of-network billing procedures required.
• Proficiency in using billing software and EMR systems required.
• Understanding of RCM best practices and metrics.
• Competency and experience with CPT, ICD-10, and HCPCS coding specific to behavioral health.
• Strong analytical and problem-solving skills, verbal and written communication skills, and organizational skills with the ability to prioritize workload and meet deadlines.
• Excellent interpersonal and conflict resolution skills with ability to work effectively in a time environment across all departments.
• Understanding of diverse cultures and gender specific issues and the ability to incorporate needs of gender and culturally diverse groups into the organization.
• Exhibits excellent customer relation skills as evidenced by supportive and constructive communication with all contacts including coworkers, patients, stakeholders, payors, contractors, visitors, families, and referral sources.

Non-Discrimination Statement:

Great Midwest Group and Midwest Behavioral Health are equal opportunity employers. All aspects of employment including the decision to hire, promote, discipline, or discharge, will be based on performance as aligned with our Mission, Vision, and Five Areas of Focus. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law. We believe there is power in diversity and that a diverse workforce representing the people and communities we serve is critical to our success and the quality of our care.

Job Tags

Similar Jobs