Billing Solutions Manager
Our mission: to eliminate every barrier to mental health.
Spring Health is the leading comprehensive mental health benefit for employers. We help employees understand their mental health issues and connect with best-in-class providers to get the right treatment at the right time.
From early detection to full recovery, Spring Health is the only clinically validated solution in the market proven to be more effective than traditional mental healthcare. By combining the latest technology with vetted providers, we help engage 1 in 3 employees, reduce recovery times, and lower healthcare costs. We are an award-winning, passionate, and mission-driven team with the support of leaders in psychiatry. We have raised over $100M to date from prominent VCs including Tiger Global, Northzone, Rethink, Work-Bench, RRE, and General Catalyst.
We are looking for a Billing Solutions Manager to join our team that will report directly to the Director of Health Plan Operations. You will be focused on the oversight of all payer contracting, benefits, EDI / ERA implementation and systems, and claims adjudication. The Billing Solutions Manager will be responsible for managing our relationships with internal and external stakeholders to resolve claims issues.
What you’ll be doing:
- Responsible for all things within the billing and benefits realm of the organization (e.g. billing, invoicing, eligibility, benefits, cost transparency, claims adjudication).
- Provide oversight, support, and managerial excellence to a team of professionals who handle claims submission to various payers, communicate benefits, and work denials and aging collections.
- Monitoring, correcting, and coaching a team regarding communication best practices when working with patients regarding verifying insurance coverage, invoicing, claims, etc.
- Verify provider coding accuracy and conduct data validation audits to ensure proper documentation supports claims submission.
- Responsible for managing protected health information and following all HIPAA policy and procedure.
- Oversee activities around proper invoicing and payment collection from payers, patients, and partners.
- Resolve issues with pending, rejected or denied claims, submissions and collections.
- Monitor appeals process to payors, ensuring compliance with regulatory requirements.
- Act as a liaison with internal and external partners to resolve claims and billing issues.
- Identify trends or issues and initiate corrective action, working with Finance to improve revenue cycle management.
- Provide feedback and advice on product/technology/service improvements.
- Own ad hoc operational efficiency projects as needed by the Director of Health Plan Operations.
What we're looking for:
- Associates degree or Certified Professional Coder with at least two years in the behavioral health or medical field in a similar position.
- Strong preference for five (5) years of working experience in claims analysis/healthcare billing and implementations.
- Experience with managing a small but growing team of billing and eligibility staff.
- Knowledge of new and existing billing technologies, solutions, and platforms to maximize efficiency and quality of billing processes.
- We need someone who is not afraid to get in the weeds with their team to solve problems and enhance billing efficiencies.
- Comfortable in amorphous environments and with constantly evolving responsibilities.
- Excellent written and verbal communication skills.
- Able to multi-task and context switch!
Why you'll like working at Spring Health:
- Big mission: we're revolutionizing the mental health industry
- The challenge: make a big impact by joining a fast-growing team in its early stages
- Good benefits: we offer health, dental and vision benefits as well as access to mental health care on Spring Health
- Great people: make an impact on something that truly helps people alongside an incredible team
- We care about diversity: diversity allows us to build an excellent patient experience. We are an equal opportunity employer and we do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status
In addition to finding people who are truly excellent at what they do, we take our values at Spring Health seriously:
Members Come First We are genuine member advocates.
Move Fast to Change Lives We build with urgency and intention.
Take Ownership We extend trust and hold ourselves accountable.
Embrace Diverse Teams & Perspectives We find strength in the diversity of cultural backgrounds, ideas, and experiences.
Science Will Win We will achieve impact by innovation and evidence based frameworks.
Candor with Care We are open, honest and empathetic.