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About the Role

Release Recovery is seeking a Senior Manager/Director of Revenue Operations to lead the transition of its insurance billing operations in-house. This role involves building systems, workflows, and a team to support the company's growth, with a focus on managing the entire revenue cycle.

Responsibilities

Manage insurance billing operations from eligibility verification through final reimbursement.
Build and improve revenue cycle workflows across outpatient, partial hospitalization (PHP), intensive outpatient (IOP), and case management services.
Develop the team and infrastructure needed to support in-house operations.
Maintain internal controls that support accurate, compliant billing.
Monitor and improve clean claim rates, days in accounts receivable, authorization approval rates, denial trends, net collection percentages, and reimbursement variances.
Identify process inefficiencies and implement automation and technology solutions.
Oversee claim creation, coding accuracy, submission, payment posting, and reconciliation.
Ensure billing follows applicable CPT, HCPCS, and ICD-10 coding standards for behavioral health services.
Validate charge capture and supporting documentation before claim submission.
Manage electronic billing systems, clearinghouses, and electronic health record integrations.
Maintain current payer billing rules and submission requirements.
Develop denial prevention and appeal strategies.
Oversee clinical and administrative appeals in partnership with clinical leadership.
Analyze denial trends and implement corrective actions.
Manage accounts receivable follow-up to ensure timely claim resolution.
Lead reimbursement renegotiation efforts when appropriate.
Partner with legal, compliance, and clinical leadership on complex escalations and payer disputes.
Analyze reimbursement rates, fee schedules, and payer contract performance.
Support payer negotiations through reimbursement analysis, utilization data, and financial modeling.
Monitor payer policy changes and communicate their operational impact.
Develop revenue cycle dashboards and operational reports.
Provide leadership with insights on payer mix, reimbursement trends, collections, and operational performance.
Forecast revenue using census, payer mix, and authorization utilization.
Identify and address the causes of revenue leakage and reimbursement delays.
Ensure revenue cycle practices comply with payer contracts and applicable state and federal requirements.
Maintain HIPAA compliance and accurate billing and authorization records.
Lead internal billing audits and support external payer audits.
Partner with clinical and compliance leadership to address documentation and billing concerns.

Requirements

Proven experience in healthcare revenue cycle management, preferably in behavioral health, substance use treatment, or a related setting.
Experience building or expanding in-house insurance billing and revenue cycle operations.
Strong background in insurance billing, claims management, accounts receivable, and denial resolution.
Ability to develop workflows, establish priorities, and implement solutions in a growing organization.
Strong understanding of CPT, HCPCS, and ICD-10 coding, payer guidelines, and behavioral health billing requirements.
Proficiency with EMR/EHR platforms, clearinghouses, and revenue cycle technology.
Experience with Kipu, Collabmd, Apero, and QuickBooks is strongly preferred.
Strong analytical and problem-solving skills, with the ability to translate data into operational improvements.
Working knowledge of HIPAA, applicable OASAS requirements, and federal healthcare billing requirements.

Skills

Revenue Cycle Management
Insurance Billing
Eligibility Verification
Utilization Review
Claims Management
Payer Relations
Reimbursement
Denial Resolution
Billing Compliance
Workflow Development
Team Development
Infrastructure Development
Internal Controls
Clean Claim Rates
Accounts Receivable Management
Authorization Approval Rates
Denial Trends Analysis
Net Collection Percentages
Reimbursement Variances Analysis
Process Improvement
Automation
Technology Solutions
Claim Creation
Coding Accuracy
Payment Posting
Reconciliation
CPT Coding
HCPCS Coding
ICD-10 Coding
Behavioral Health Billing
Charge Capture Validation
Electronic Billing Systems
Clearinghouses
Electronic Health Record (EHR) Integration
Payer Billing Rules
Denial Prevention
Appeal Strategies
Clinical Appeals
Administrative Appeals
Reimbursement Renegotiation
Payer Contract Analysis
Fee Schedule Analysis
Payer Contract Performance Analysis
Reimbursement Analysis
Utilization Data Analysis
Financial Modeling
Payer Policy Monitoring
Revenue Cycle Dashboards
Operational Reporting
Payer Mix Analysis
Reimbursement Trend Analysis
Collections Analysis
Operational Performance Analysis
Revenue Forecasting
Revenue Leakage Identification
Reimbursement Delay Identification
HIPAA Compliance
Billing Audits
External Payer Audits
Documentation Improvement
Problem-Solving
Data Translation
OASAS Requirements

Location

Washington, DC
New York, NY
Austin, TX

Work Type

Full-time

Experience Level

Senior Manager
Director

Salary/Compensations

$125,000 - $145,000

Benefits

Health benefits (full-time employees)
Dental benefits (full-time employees)
Vision benefits (full-time employees)

About the Company

Release Recovery is a mission-driven organization redefining how the world views and treats substance use and mental health.
At Release, recovery is about growth, connection, and long-term transformation.
We believe recovery is a journey, not a destination, and we’re committed to shaping that journey with intention, care, and innovation.