Billing Supervisor

Description

Why Join ADAPT?

It's more than a job; it's a calling. It's where passion meets purpose. ADAPT Community Network, formerly United Cerebral Palsy (UCP) of NYC provides a multitude of services to people with developmental disabilities. At ADAPT, we are 3,000 strong, and it takes every one of us to empower the lives of the people we support. With caring and great resources at hand, we know what it takes to help people live fuller, happier, healthier lives. Our employees show their commitment to the people we support every day, and we all deliver on our promise to provide innovative and comprehensive services to individuals with developmental disabilities.

For your next career move, apply with us at ADAPT Community Network! Wherever you work among our many locations around New York City, ADAPT offers paid training, competitive benefits, and we foster a team culture of learning, support, collaboration and career growth.

SUMMARY

Under the general supervision of senior leadership, the Billing Manager is responsible for overseeing the revenue cycle for OPWDD programs and Article 28 clinical services. This position ensures accurate, compliant, and timely billing in accordance with ADAPT Community Network policies and procedures, applicable federal and state regulations, payer requirements, and professional standards. The Billing Manager leads billing operations, monitors compliance with regulatory requirements, optimizes reimbursement, resolves billing discrepancies, and supports financial reporting and revenue integrity initiatives in collaboration with Finance, Compliance, Quality Assurance, and Program leadership.

ESSENTIAL DUTIES AND RESPONSIBILITIES

The key duties and responsibilities of the Billing Manager include but are not limited to:

OPWDD Billing & Compliance

• Manage billing processes for OPWDD services including but not limited to Community Habilitation, Day Habilitation, Respite, Supported Employment, Care Coordination / Health Home Care Management, Residential Services, Assistive Supports, and Representative Payee Unearned Income
• Ensure compliance with OPWDD, DOH, Medicaid, and HCBS waiver billing requirements.
• Oversee accurate service documentation, encounter data, and billing submission timelines.
• Conduct routine audits to ensure clean claims and correct service authorizations (e.g., DDP-2, LOCs, TABS/CHRC consistency).
• Track and resolve billing edits and rejections in eMedNY and managed care portals.
• Monitor updated OPWDD billing guidance, rate changes, and revenue cycle regulations.

Article 28 Billing & Revenue Cycle Management

• Manage billing for clinics licensed under Article 28, including primary care, behavioral health, specialty services, rehabilitation services, and ancillary testing.
• Oversee claims submission for Medicaid FFS, Medicare, Medicaid Managed Care, and commercial payers.
• Verify patient insurance eligibility, authorizations, referrals, and required documentation.
• Ensure compliance with Article 28 billing standards, APGs (Ambulatory Patient Groups), and DOH regulations.
• Oversee coding (ICD-10, CPT, HCPCS) accuracy and collaborate with clinical staff on documentation improvement.
• Monitor denials, rejections, incorrect coding, and partial payments, driving resolution and financial recovery.

Leadership & Operational Oversight

• Supervise billing team members, establishing clear performance expectations and productivity standards.
• Develop workflows, SOPs, and KPI dashboards for improved billing efficiency and revenue performance.
• Train staff on OPWDD and Article 28 billing practices, system updates, and compliance requirements.
• Coordinate closely with Finance, Compliance, Quality Assurance, and Program Directors.

Systems & Reporting

• Maintain proficiency in billing and EHR systems (e.g., eMedNY, EPaces, billing software, clearinghouses, and EMRs).
• Generate monthly revenue cycle reporting on AR aging, collections, denial rates, and payer trends.
• Partner with the Finance team to support month-end close and revenue forecasting.
• Identify billing risks and opportunities, recommending process improvements and system enhancements.
• All other duties as required.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

REQUIRED

• Bachelor’s degree in Health Care Administration, Accounting, or related field required.
• Minimum five (5) years of healthcare billing experience required.
• Minimum three (3) years of supervisory experience required.
• Demonstrated experience with OPWDD and Article 28 billing required.
• Knowledge of Medicaid, Medicare, Managed Care, and regulatory billing requirements.
• Knowledge of CPT, HCPCS, and ICD-10 coding standards.
• Experience with electronic medical record and billing software systems.
• Strong analytical, organizational, communication, and problem-solving skills.
• Passion for ADAPT's mission and demonstrates a commitment to the non-profit disability sector.

PREFERRED

• Experience with OPWDD billing and compliance platforms.
• Familiarity with state billing portals and encounter reporting systems.
• Experience with value-based payment or quality incentive programs.
• Advanced spreadsheet and financial reporting skills.

COMPENSATION: $70,000 - $80,000 Annually + Industry-Leading Benefits!

At ADAPT, we value diversity, equity, inclusion, accessibility, and belonging. We strive to ensure that our employees are comfortable bringing their whole, authentic self to work and that the people we support can also be their authentic selves. We value diverse backgrounds, opinions, ideas, and ways of thinking. We aim to build an inclusive and diverse workforce that is empowered and supported with leaders who create diverse and inclusive teams. We continuously seek opportunities for the organization to foster a more positive, respected, united, and collaborative culture.

ADAPT Community Network is proud to be an equal opportunity employer and is committed to creating an inclusive environment for all employees. Qualified candidates of diverse ethnic and racial backgrounds and status are encouraged to apply for vacant positions at all levels.