Claims and Remittance Processing Manager

Behavioral Health Network (BHN), the largest provider of behavioral health services in Western Massachusetts, is seeking a skilled and analytically minded Claims & Remittance Processing Manager to join our Revenue Cycle Management team. Recognized by The Boston Globe as one of the Top 10 Employers in Massachusetts and certified as a Great Place to Work, BHN continues to set the standard for operational excellence, compassionate care, and innovation in healthcare delivery. What You’ll Do As the Claims & Remittance Processing Manager, you will lead a team responsible for ensuring the accuracy, timeliness, and compliance of all claims submissions and remittance processing. You will play a critical role in optimizing BHN’s revenue cycle operations, streamlining workflows, and supporting continuous improvement initiatives across the organization. You Will • Lead and mentor the Claims Submission and Payment Posting teams. • Oversee the timely and accurate submission of 837 professional and institutional claims. • Manage the compliant posting of payments, adjustments, and denials from electronic remittance files. • Analyze claims and remittance data to identify trends, errors, and opportunities for improvement. • Collaborate with cross-functional partners in IT, Finance, and Clinical departments to resolve issues and optimize processes. • Implement project management principles to streamline operations and improve performance metrics. What We Offer • Mission-Driven Work – Contribute to BHN’s goal of ensuring financial sustainability that supports life-changing care across Western Massachusetts. • Comprehensive Benefits – Competitive salary, generous PTO, health/dental/vision coverage, tuition reimbursement, and a 403(b) retirement plan. • Professional Growth – Access to ongoing development opportunities and leadership advancement within one of Massachusetts’ top healthcare organizations. • Collaborative Culture – Join a highly skilled team dedicated to innovation, accountability, and excellence in revenue cycle management. • Impactful Leadership – Play a key role in improving clean claim rates, first-pass payment success, and cash flow performance. Key Responsibilities • Lead the Claims Submission and Payment Posting teams, ensuring efficient operations and staff development. • Drive improvements in Days in Accounts Receivable (A/R), clean claim rate, and first-pass payment success. • Conduct regular audits of staff-processed claims and postings to ensure accuracy and compliance. • Develop and maintain standard operating procedures (SOPs) and internal documentation. • Serve as a subject matter expert (SME) for payer requirements, EDI transactions, and system workflows. • Collaborate with payers and clearinghouses to resolve complex billing and reimbursement issues. • Lead root cause analyses of denials and underpayments, recommending corrective actions. • Support the Director of Revenue Cycle Management in key performance reporting and process redesign initiatives. Who You Are • Bachelor’s Degree in Healthcare Administration, Business, or related field (required) – or equivalent experience. • 4–6 years of progressive experience in revenue cycle operations, including 837/835 transactions (required). • 3+ years of leadership experience managing billing or remittance teams (preferred). • Strong knowledge of MassHealth, commercial payer rules, and healthcare billing regulations. • Experience with behavioral health billing and EHR systems such as CareLogic, Credible, or Athena. • Excellent analytical, problem-solving, and communication skills. • Collaborative and adaptable leader with a commitment to continuous improvement. About Us Since 1938, Behavioral Health Network (BHN) has been committed to delivering high-quality, affordable, and culturally responsive care across Western Massachusetts. With over 130 programs and 3,000 employees, we are proud to serve our communities through innovation, compassion, and excellence in behavioral health and human services. How to Apply If you’re ready to make a measurable impact on the financial health and operational success of one of Massachusetts’ top healthcare organizations, we’d love to hear from you! Click “Apply for Job”. Apply tot his job Apply To this Job