A growing and dynamic health center is looking for a Medical Billing Supervisor to play a crucial role in ensuring effective revenue cycle management, compliance, and quality standards within our healthcare organization, which is working toward becoming an FQHC. You will oversee all activities and staff in the billing function, ensure timely and accurate billing, oversee provider credentialing and enrollment, and manage the collection process from third-party payors and patients. You will develop and implement policies and procedures, coordinate staff, maintain accurate medical record information, achieve revenue targets, and optimize patient financial interaction. The incumbent will play a crucial role in ensuring the accurate and timely credentialing of healthcare providers with insurance companies and managed care organizations (MCOs).

Specific Responsibilities and Duties:

1. Supervision: Supervise all activities and staff in the billing function, provide direction, monitor work, coach, and conduct performance management.
2. Conduct monthly staff meetings and audits.
3. Maintain clearinghouse and insurance portal access.
4. Billing Processes: Monitor 3rd party billing company performance
5. Ensure accurate and timely processing of claims, correction of rejected and denied claims.
6. Oversee the preparation and submission of electronic billing to fiscal intermediaries.
7. Manage write-offs and review reports monthly.
8. Implement billing software and clearinghouse changes, maintaining up-to-date information.
9. Assist in all billing processes, as needed
10. Credentialing: Review and process credentialing and enrollment applications for healthcare providers with insurance companies and MCOs
11. Own all aspects of provider privileging, credentialing, and enrollment
12. Verify the accuracy and completeness of application materials, ensuring compliance with regulatory standards and organizational policies
13. Maintain accurate and up-to-date provider credentialing files in conjunction with key stakeholders or contractors
14. Communicate with insurance companies, MCOs, and other stakeholders to resolve credentialing and enrollment issues and inquiries
15. Assist in the development and implementation of credentialing and privileging policies and procedures
16. Collaborate with internal teams, including revenue cycle and operations teams, to ensure timely completion of credentialing processes

1. Patient Financial Advocacy: Oversee the patient financial aid process, ensuring accurate application of the Sliding Fee Discount Scale.
2. Reports and Analysis: Generate, review, and submit electronic patient statement files monthly.
3. Oversee all aspects of billing processes.
4. Prepare billing and financial reports for month-end.
5. Compliance and Quality: Implement and revise policies and procedures for timely and accurate billing.
6. Ensure current billing practices comply with governmental rules and regulations.
7. Investigate and resolve billing discrepancies and errors.
8. Training and Development: Provide staff training and development to ensure compliance with procedures, increase revenue, and maintain a successful patient experience.
9. Support Quality and Compliance Departments with patient grievances and resolution.
10. Additional Duties: Assist with departmental audits.
11. Board meetings as needed.
12. Perform other duties as assigned
13. Collaborate, teach, and function effectively in a teaching organization.
14. Assist with referral management, medical record requests, and quality improvement and assurance activities, as needed.
15. Demonstrate cultural sensitivity and respect for diversity.