Behavioral Health Billing Manager

MUST BE PHYSICALLY LOCATED IN WASHINGTON STATE FOR THIS REMOTE POSITION

Location: Remote — must be physically based in Washington State. Out-of-state candidates will not be considered.

Hours: Approximately 25–35 hours/week and growing, with a defined path to full-time salaried

Pay: $30.00 – $35.00 per hour, depending on experience — W-2 employment

Application Contact: Lindsey@TalkHealThrive.com

About Us:

Talk. Heal. Thrive. Psychotherapy is a growing private group practice based in Seattle, Washington, providing therapy services exclusively via telehealth to clients across Washington State. Our team includes roughly 35 clinicians serving clients on Apple Health (Medicaid) managed care plans as well as commercial insurance.

About This Role:

The role is currently 25–35 hours per week and is growing steadily. Once the work is consistently at 40 hours per week, this position will convert to a salaried role with additional benefits.

You will not be building this from scratch. We have established billing processes and documentation already in place. What we need is someone who can step into that system, learn it, run it well — and then keep asking how to make it better.

As the practice grows, the billing operation has to grow with it, and we want someone who sees that as the interesting part of the job rather than an inconvenience.

You will work independently, set your own daily rhythm within business hours (8am-5pm M-F), and be trusted with real ownership of how billing runs here. In exchange, we need someone dependable and consistent. The kind of person who closes the loop without being asked.

What You'll Do

(Responsibilities will grow and change as the practice grows.)

Daily claim operations:

File claims daily for locked and signed clinical notes.
Audit filed claims for accuracy before and after submission — catching errors at the front end rather than reworking denials at the back end.
Verify insurance payments and adjustments posted in the SimplePractice EHR and reconcile against expected contracted rates.
Monitor aging: Any claims that are not filed within 7 days need to have follow up with clinician's to sign and lock documentation so claims can be filed.

Denials, clawbacks, and payer follow-up:

Work denied and rejected claims on a weekly basis — every denial is either resolved or understood and actively tracked.
Maintain a running status list of open denials, appeals, and payer escalations that the owner can review at any time.
Call payers directly and escalate when a first-level response is wrong.
Track denial patterns over time, identify root causes, and fix the upstream process rather than just reworking the individual claim.
Manage recoupment and clawback requests: determine why the takeback occurred, resolve or appeal it, and update our systems so the same issue doesn't recur.
Work Washington Apple Health (Medicaid) claims through managed care organizations, as well as commercial payer claims.
Navigating all the various payer portals and working with our credentialing specialist if issues arrive around credentialing.

Client and clinician support:

Manage insurance issues directly with clients and clinicians — explaining coverage problems clearly and walking people through resolution.
Review coordination of benefits flags surfaced by our automated system and follow up on any coverage conflicts or eligibility issues.
Follow up on declined credit card payments and other client payment failures.
Collaborate with the broader team on billing questions tied to individual clients.
Document all payer and client interactions in SimplePractice.

Team leadership:

Direct and support the Billing Assistant, who handles insurance calls and takes on research and follow-up work that you assign.
Delegate deliberately — use the assistant's capacity to free yourself for the complex cases that need your judgment.

Systems and process improvement:

Maintain and update our existing standard operating procedure documentation as processes evolve, so the system stays accurate and transferable.
Continuously evaluate our current workflows for ways to streamline, automate, or strengthen them — and bring those recommendations forward.
Conduct regular audits of clinician and client insurance information for missing or outdated data.
Coordinate with the credentialing side of the practice on payer enrollment issues that affect claim payment.
Produce regular reporting on AR, denial rates, and collections so the owner can see where the money is.
Bring feedback and recommendations directly to the practice owner on how to keep streamlining the system.

Required Qualifications:

Working knowledge of Washington State payer systems — behavioral health billing for both Medicaid/Apple Health managed care organizations and commercial payers. This is not a role we can train from scratch.
Comfort with the SimplePractice EHR. You should be able to hit the ground running in the system, not learn it on our time.
Demonstrated experience resolving denied claims independently — including reading remittance advice, identifying the actual denial reason, and pursuing corrected claims and appeals through resolution.
Genuine enjoyment of this work. The best people in this role find denial resolution satisfying rather than draining, and we are looking for that.
Process-minded thinking — the instinct to ask why something broke, how to keep it from breaking again, and the discipline to write the fix down.
A leadership mindset. You are stepping into an established process, but we want someone who will take ownership of it, grow with the practice, and keep pushing the billing operation toward greater efficiency over time.
High attention to detail and consistent, repeatable processes.
Dependability and consistency. Hours are flexible, but there are daily assignments that must be completed Monday through Friday, and we need someone who closes the loop without being chased.
Ability to work independently and self-motivate in a fully remote environment.
Collaborative team player — comfortable working across the clinical and administrative teams on client-specific billing issues.
Clear, professional, and compassionate communication with payers, clients, and clinicians.
Willingness to identify inefficiencies and collaborate to correct them.
Physically based in Washington State.
Access to reliable high-speed internet and a computer with a camera for virtual meetings.

Preferred Qualifications:

Prior experience in a behavioral health or mental health practice setting.
Experience managing payer recoupments, clawbacks, or post-payment audits.
Medical coding knowledge or certification (CPC, CPB, or similar).
Experience improving or optimizing an existing billing workflow — reducing denial rates, shortening days in AR, or automating manual steps.
Prior experience in a lead, supervisory, or manager role.

Compensation and Benefits:

Hourly rate: $30.00 – $35.00 per hour, depending on experience. W-2 employment.
Medical benefits: Eligible the first of the month following 60 days of employment. Talk. Heal. Thrive. covers 75% of health care premium costs.
401(k): Eligible after 3 months. Company match of 100% up to 3% and 50% up to the next 6% — a total match of 4.5% if you contribute 6%.
Paid sick leave: Accrued at 1 hour for every 40 hours worked, per Washington State law.
Technology stipend: $600 per year, paid at $50/month (or $25 per biweekly pay period), to help offset technology costs.
Holidays: Eight recognized holidays per year (unpaid time off).
Schedule flexibility: Set your own hours within Monday–Friday business hours, as long as daily tasks, calls, and emails are handled.

How to Apply:

Email Lindsey@TalkHealThrive.com with your resume and a short note about what interests you in this position. Please include a brief description of your experience with Washington Medicaid managed care billing and how you typically approach a denied claim.

Talk Heal Thrive Psychotherapy

Behavioral Health Billing Manager

About the Job