FQHC Billing Manager

JOB SUMMARY:

The position of Billing & Credentialing Manager is responsible for streamlining effective revenue cycle operations of the billing department in compliance with FQHC billing guidelines and maintaining integrity of all billing data and maintaining credentialing criteria in accordance with respective payers. This position works closely with leadership and develops best practices in revenue cycle management approaches and efficient methods of billing/collection and credentialing processes. This position ensures accurate billing and collections and oversees accounts receivables.

JOB DUTIES AND RESPONSIBILITIES:

· Manages Billing Department which includes supervising two onsite billers and one remote biller.

· Maintains Provider Enrollment & Credentialing to ensure accurate provider/site enrollment with payers and correct set up in EHR.

· Alerts leadership of billing concerns and issues.

· Responsible for all claim submissions electronic and paper claims.

· Retrieves ERAs (Electronic Remittance Advice) from clearinghouse when applicable and uploads to EHR.

· Ensures all payments are settled correctly for all payers.

· Uses EHR documentation to verify correct coding and medical necessity.

· Codes and bills OB/Gyn and Gastroenterologist hospital procedures and surgeries.

· Research and initiates activity to resolve charges and coding issues.

· Maintains knowledge of current industry regulations and insurance requirements and communicates updates accordingly.

· Participates in efforts to improve clinical efficiencies and achievement of new performance standards.

· Responsible for billing/coding audits for all services/providers and works with providers/staff to correct billing/coding issues when applicable.

· Assists with billing and training for Value Based Care incentive payments.

· Assists and/or prepares various reports as necessary required to complete annual UDS and annual Medicare Cost Report.

· Completes request for billing records.

· Monitors billing key performance indicators and claims dashboard in EHR.

· Assists patients with billing concerns.

JOB REQUIREMENTS AND EDUCATION:

· Demonstrates flexibility and emotional control in handling difficult or stressful situations.

· Communicates with patients in a caring, professional manner while treating everyone equal.

· Possesses good organizational skills and is self directed.

· Experience posting insurance payments, electronic claim submission, and EDI transactions.

· Strong working knowledge of principles and practices of FQHC revenue cycle.

· Experience and working knowledge of Excel, MS Word, and EHR.

· Ability to communicate effectively both orally and in writing in a timely manner and relate to vendors, auditors and staff at all levels in the organization.

· Ability to take directions and complete tasks on time.

· High school graduate or equivalent.

· Preferred Certified Coder (CPC, CCS-P) with credential from either AAPC or AHIMA.

· Knowledge of medical terminology, anatomy & physiology.

· Knowledge of Medicare and Medicaid FQHC billing guidelines.

· Participates in community awareness.

· Ability to respond effectively to inquiries about organization services.

Job Type: Full-time

Pay: $65,000.00 - $72,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work Location: In person

Salary : $65,000 - $72,000