Job Description
Job Description
Benefits :
- 401(k) matching
- Competitive salary
Role Summary
The Billing Lead oversees EverCares billing operations, ensuring timely, accurate, and compliant revenue capture across multiple states and from multiple payers. This role demands both hands-on technical expertise and leadership : someone who understands the inner workings of multiple EHRs / billing systems, can drive process improvement, optimize reimbursement strategies, ensure audit readiness, and build a high-performing billing team that supports the mobile mental health care model inside long-term care facilities.
Key Accountabilities
Team Leadership & DevelopmentLead, manage, and hold accountable the billing team - including credentialing, claims specialists, and billing professionals - to ensure accuracy, efficiency, and compliance in all billing operations while driving consistent cash flow and organizational success.
Hire, onboard, train, mentor, and evaluate team members.Build a culture of continuous improvement, accountability, and collaboration.Claims & Insurance ManagementOversee timely and accurate preparation, submission, and follow-up on claims for 13+ payers across multiple states.
Ensure insurance verification processes are reliable and efficient.Apply payer-specific knowledge and coding sequence strategies to maximize allowable reimbursements while staying fully compliant.Manage and monitor payer portals for claim status, rejections, and communication.Credentialing & Provider EnrollmentEnsure providers are properly credentialed / enrolled with payers; monitor renewals to avoid lapses.
Liaise with payers and networks to manage enrollments, re-enrollments, and new payer additions.Coding & Documentation OversightEnsure proper CPT / ICD coding and documentation to support claims.
Optimize reimbursement through accurate code ordering, modifier usage, and alignment with payer rules.Revenue Cycle OptimizationMeasure, monitor, and improve revenue cycle KPIs (A / R days, denial rate, clean claim rate, etc.).
Track, reconcile, and manage accounts receivable to minimize aging and improve collections.Continuously refine billing practices to capture the maximum legitimate revenue possible.Technical & System ManagementManage and evaluate multiple EHR / billing software tools.
Lead system migrations / upgrades ; ensure data integrity and minimal disruption.Utilize reporting tools and dashboards to provide actionable insights for leadership.Compliance & Audit ReadinessStay current with payer regulation changes, state Medicaid / Medicare rules, and coding updates.
Maintain compliant billing practices; ensure documentation satisfies audit requirements.Conduct regular internal audits and prepare for external reviews as needed.Reporting & Financial OversightProvide regular revenue and billing performance reports to the Finance Lead.
Forecast revenue, including impacts of denials, rate changes, or payer delays.Manage billing department budget and vendor relationships.Policy, Procedures & DocumentationWrite, maintain, and update Standard Operating Procedures (SOPs) for all billing processes.
Ensure staff adhere to procedures and perform internal process audits.Stakeholder CollaborationWork closely with clinical and operations teams to ensure documentation supports billing.
Engage payer representatives for escalated or complex issues.Coordinate with IT for system integration, data extraction, and vendor management.Qualifications
Certified Professional Biller (CPB), Certified Professional Coder (CPC), or equivalent strongly preferred.Minimum 57 years of experience in medical billing / revenue cycle, including leadership / supervisory responsibilities.Experience with multiple EHR / billing systems, including billing migrations.Proven success leading a billing team and managing change.Strong understanding of mental / behavioral health billing; care management billing highly desirable.Long-term care facility billing experience a plus.Multi-state billing knowledge (currently Oregon and Idaho; expansion expected).Tech-forward mindset with comfort in adopting new tools, reporting systems, and data dashboards.Excellent analytical, problem-solving, and communication skills.Must be familiar with insurers in Idaho and Oregon.Success Metrics / KPIs
A / R aging maintained under target threshold.Denial rate reduced year-over-year.Clean claim submission rate at or above target.Credentialing completed on time, with no lapses.Revenue collections consistently align with allowable payer reimbursements.Forecasted vs. actual revenue within acceptable variance.Attributes / Fit
Tech-forward and adaptable, eager to leverage tools and automation.Process-oriented and detail-driven.Thrives in a fast-growth EOS company, balancing structure with adaptability.Strong ethics and compliance mindset.Clear and confident communicator across staff, leadership, and external partners.Core Values Alignment
At EverCare, our team members live out these values every day :
Help First : Give abundantly. Serve without expecting.Embrace Change : Stay flexible. Keep learning. Grow stronger. Enjoy the ride.Have Fun, Get Stuff Done : Bring joy. Get it done. Be yourself.Built on Trust, Kept by Loyalty : Do what you say. Build trust. Take ownership.Be Bold : Care deeply. Act wisely. Create together. Inspire change.The Billing Lead is expected to model these values in every aspect of leadership and decision-making, ensuring the billing function not only performs at a high level but also reflects the culture we are committed to building.
This is a remote position.
