Billing Manager

Company Overview

Spruce Psychiatric Associates is a practice management company built to help independent psychiatric providers thrive.

We support providers with the operational infrastructure behind their practices, including billing, credentialing, administrative support, technology, and practice operations. By reducing administrative burden and helping providers navigate the business side of healthcare, we create an environment where clinicians can grow with greater independence, stability, and confidence.

We believe that when clinicians are well supported, their patients get better care.

Position Overview

Spruce Psychiatric Associates is seeking a full-time Billing Manager to lead and strengthen our billing operations as the company continues to grow.

Reporting to the Practice Manager, this role is responsible for overseeing the billing team, optimizing revenue cycle workflows, improving performance and accountability, and helping ensure accurate, timely reimbursement across the practices we support.

The ideal candidate is an experienced healthcare billing professional and collaborative people leader who enjoys building strong teams, improving systems, solving operational problems, and creating structure in a growing organization.

This is an opportunity to take meaningful ownership of a key operational function and help shape the billing infrastructure needed to support Spruce’s continued growth.

Key Responsibilities

Leadership & Team Management

• Oversee the day-to-day operations and performance of the billing team.
• Set clear expectations, priorities, and performance standards.
• Conduct regular individual meetings with billing team members.
• Provide coaching, feedback, training, and professional development.
• Address performance, communication, attendance, or accountability concerns constructively and promptly.
• Partner with the Practice Manager on staffing, hiring, employee development, and significant personnel matters.
• Foster a collaborative, accountable, and supportive team environment.

Revenue Cycle & Billing Operations

• Oversee core billing functions, including claims submission, payment posting, accounts receivable, denials, patient balances, collections, and reconciliation.
• Ensure billing responsibilities are completed accurately and within expected timelines.
• Monitor workloads, backlogs, and capacity across the department.
• Coordinate coverage during absences and staffing changes.
• Serve as an escalation point for complex, recurring, or financially significant billing issues.
• Work closely with the Lead Billing Coordinator on workflow, technical billing issues, training, and operational priorities.

Metrics & Performance

• Maintain and review meaningful individual and department-level billing metrics.
• Monitor work queues, aging items, productivity, claims performance, and other key indicators.
• Identify recurring errors, backlogs, and performance concerns early.
• Determine whether issues relate to workload, training, process, staffing, or individual performance.
• Use data to improve collections, accuracy, efficiency, and departmental performance.
• Keep the Practice Manager informed of significant trends and concerns.

Process Improvement & Training

• Establish and maintain consistent billing procedures and workflows.
• Identify inefficiencies and opportunities for process improvement or automation.
• Ensure significant process changes are documented and communicated clearly.
• Maintain billing procedures and resources within the company’s shared knowledge base.
• Identify training needs and ensure new employees receive appropriate onboarding and support.
• Promote cross-training and reliable backup coverage for essential billing functions.

Payer, Patient & Provider Support

• Maintain awareness of significant payer, reimbursement, denial, and claims-processing issues.
• Coordinate resolution of recurring reimbursement and reconciliation problems.
• Identify payer trends that may require workflow changes, outreach, or provider education.
• Support the team in resolving complex patient billing concerns.
• Help ensure billing communication with patients, providers, and insurance companies is clear, accurate, and professional.
• Escalate material financial, contractual, compliance, or operational concerns when appropriate.

Collaboration & Communication

• Serve as the primary management contact for the billing department.
• Work closely with the Practice Manager on departmental goals, staffing, performance, and strategy.
• Collaborate with providers, intake, front desk, and other administrative teams to resolve cross-functional issues.
• Communicate billing policies, priorities, and process changes clearly.
• Bring forward both identified problems and thoughtful recommendations for improvement.

Education & Experience

• 5 to 7 years in healthcare billing or revenue cycle management is required.
• 2 to 3 years of experience leading or supervising a healthcare billing or revenue cycle team is required.
• Experience in an outpatient healthcare environment strongly preferred;
  behavioral health or psychiatry experience is a plus.
• Excellent knowledge of commercial insurance billing, claims processing, and reimbursement.
• Experience with accounts receivable, denials, payment posting, reconciliation, and patient balances.
• Strong knowledge of CPT and ICD-10 coding concepts.
• Experience with Electronic Health Record and Practice Management systems.
• AdvancedMD experience is a plus but not required.

Knowledge & Skills

• Strong leadership and people-management skills.
• Excellent analytical, organizational, and problem-solving abilities.
• Ability to set expectations and hold team members accountable professionally and constructively.
• Strong written and verbal communication skills.
• Comfort working with billing metrics, spreadsheets, and performance data.
• High attention to detail and sound judgment.
• Ability to identify root causes and develop practical operational solutions.
• Collaborative working style and ability to adapt in a growing organization.

What Success Looks Like

A successful Billing Manager will create a billing department that is organized, accountable, and able to support the continued growth of Spruce.

Success in this role includes maintaining reliable performance visibility, identifying backlogs and operational issues early, developing a strong and well-supported billing team, improving workflow consistency, reducing avoidable errors, and ensuring significant payer and reimbursement issues receive appropriate follow-up.

Job Type

Full-time

Location

Seattle, WA 98107

Compensation

Salary: $80,000 – $110,000 depending on experience

Benefits

• 85% employer covered Medical and Vision insurance
• 401(k) with 4% employer match and profit sharing
• 15 days of Paid Time Off per year
• 8 paid public holidays per year
• Paid sick leave

Spruce Psychiatric Associates is an equal opportunity employer. Employment decisions are based on qualifications, experience, performance, and business needs without regard to any status protected by applicable federal, state, or local law. It is a conflict of interest to be both a client and employee of Spruce Psychiatric Associates.

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