Billing Manager- Community Health Organization

Optimus Healthcare- A federally qualified Community Health Center driven by one mission: to provide high quality, affordable healthcare to the underserved population regardless of their ability to pay. Optimus is the largest Federally Qualified Health Center providing primary care services in lower Fairfield County, in the cities of Stamford, Bridgeport, Stratford and surrounding areas. If you are a healthcare professional who wants to work in a meaningful, mission-driven workplace where people are committed and passionate about caring for others, OPTIMUS may be for you.

We are recruiting for a full-time Billing Manager to join our team in Stratford, CT POSITION SUMMARY

The FQHC (Federally Qualified Health Center) Billing Manager is responsible for overseeing all aspects of the billing process for the health center. This includes managing the billing staff, ensuring compliance with federal and state regulations, and optimizing revenue cycle management. Working with the Director of Revenue Cycle, the Billing Manager will establish effective claims management processes and controls to ensure the accuracy and timeliness of claim submissions and collections efforts while maintaining compliance with contractual, state, and federal regulations. The Billing Manager will proactively identify, develop, and execute solutions to improve overall effectiveness and efficiency within the billing and collections area, to ensure the billing staff are meeting and/or exceeding key performance metrics.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES

• Billing Operations Management:
  • Assist with the daily oversite of the operations of the billing department, ensuring accurate and timely submission of claims.
  • Monitor billing processes to ensure compliance with federal, state, and local regulations.
  • Implement and maintain billing policies and procedures to optimize efficiency and effectiveness.
• Revenue Cycle Management:
  • Assist with the development and implementation of strategies to improve revenue cycle performance.
  • Analyze and report on key performance indicators (KPIs) related to billing and collections.
  • Identify and resolve issues related to claim denials, rejections, and underpayments.
• Staff Management:
  • Supervise and mentor billing staff, providing guidance and training as needed.
  • Conduct performance evaluations and address any performance issues.
  • Ensure the billing team is up to date with changes in billing regulations and practices.
• Compliance and Quality Assurance:
  • Ensure all billing practices comply with applicable laws and regulations, including HIPAA.
  • Conduct regular audits of billing activities to identify and correct errors.
  • Work with the compliance officer to address any compliance issues.
• Technology and System Management:
  • Oversee the implementation and maintenance component of billing software and systems.
  • Work with IT staff to troubleshoot and resolve system issues.
  • Ensure data integrity and security within billing systems.
• Collaboration and Communication:
  • Work closely with other departments, including clinical, compliance, administration, and finance, to ensure smooth operations.
  • Assist financial management with quarterly and annual financial reporting of billing and receivable data. Assist in creating all data necessary to support non-Medicaid contracts, IRS990 and other reports as needed.
  • Communicate regularly with management regarding billing issues, challenges, and performance.
  • Participate in management meetings and contribute to strategic planning.
• Patient Relations:
  • Address patient inquiries and concerns related to billing.
  • Ensure patient billing statements are accurate and understandable.
  • Implement processes to enhance patient satisfaction with billing services.

JOB QUALIFICATIONS/REQUIREMENTS

• Strong understanding of medical billing and coding practices.
• Knowledge of FQHC billing requirements and regulations.
• Excellent leadership and team management skills.
• Proficiency in billing software and electronic health records (EHR) systems; EPIC preferred
• Strong analytical and problem-solving abilities.
• Excellent communication and interpersonal skills.
• Demonstrated ability to analyze complex problems and to arrive at sound decisions or recommendations.
• Knowledge of financial reporting in a community healthcare environment and to effectively operate within budget constraints.
• Must be able to work a flexible schedule when required

EDUCATION: Bachelor’s degree in healthcare administration, business, or a related field preferred.

EXPERIENCE: Minimum of 5 years of experience in medical billing, with at least 2-3 years in a supervisory or management role. Experience working in an FQHC or similar healthcare setting is highly preferred.

LANGUAGE SKILLS: Bi-lingual English/Spanish is helpful but not required.

LICENSURE / CERTIFICATION: CCA, CPB, CMRS or CPC certification desirable

STANDARD REQUIREMENTS

• Supports an ethical standard which complies with a code of conduct free of conflicts of interest.
• Supports the Mission and Values of Optimus Health Care, Inc.
• Supports, cooperates with, and implements specific procedures and programs for:
  • Safety, including universal precautions and safe work practices, established fire/safety/disaster plans, risk management, and security, report and/or correct unsafe working conditions, equipment repair and maintenance needs.
  • Confidentiality of all data, including patient, employee, and operations data.
  • Quality Assurance and compliance with all regulatory requirements.
  • Compliance with current law and policy to provide a work environment free from sexual harassment and all illegal and discriminatory behavior.
• Supports and participates in common teamwork:
• Cooperates and works together with all co-workers; plan and complete job duties with minimal supervisory direction, including appropriate judgment.
• Uses tactful, appropriate communications in sensitive and emotional situations.
• Follows up as appropriate with supervisor and co-workers regarding reported complaints, problems, and concerns.
• Promotes positive public relations with patients, family members and guests.

• OHC provides a fun, fast-paced working environment, where our commitment to quality is present in every job function.
• 100% Outpatient Setting
• Excellent health & welfare benefit options
• Competitive Compensation
• Optimus and its caring, multilingual staff proudly serve our community in a patient-centered environment