Job Description
Job Description
Starting salaries are set in accordance with our compensation plan, which considers multiple individual and organizational factors, including internal equity. To uphold pay equity in alignment with the compensation plan, starting salary ranges are not negotiable. Before applying, please ensure that the compensation for this position meets your needs.
Our Mission
To promote the well-being of the underserved by providing access to high-quality healthcare for all, regardless of ability to pay.
Our services, activities and governance reflect the Islamic values and moral principles which inspired our founders. These include the core values which are universally shared and revered by society at large : Service, Compassion, Human Dignity, Social Justice, and Ethical Conduct.
Working at UMMA
UMMA is looking for passionate and mission-driven Staff who look to make an impact on the lives of our patients and the members of our community. These roles include Physicians and Medical Staff, Behavioral Health Staff, Administration, and more! For more information on the services we provide, Click Here
Benefits and Compensation
UMMA offers a competitive compensation and benefits package with comprehensive and cost-effective medical plans. Benefits package includes Medical, Dental, Vision, AD&D and Supplemental Life Insurance, Employee Assistance Program Tuition Reimbursement, loan repayment opportunities, 403(b) savings plan, employee discounts, extended lunch on Fridays, and more!
Our compensation plan also includes Paid Holidays, Paid Time Off (accruals begin on the first day of hire), Employee Recognition, and more!!
Summary
The Billing Coder and Revenue Cycle Analyst is responsible for bridging billing operations, program data management, and EMR configuration to ensure accurate, efficient, and compliant workflows. This role involves configuring and optimizing the EMR for billing, analyzing data to enhance revenue cycle performance, and support training and system improvements.
Essential Duties
Billing and Revenue Cycle Management :
- Configure and optimize the EMR system for accurate and efficient billing workflows.
- Ensure CPT, ICD, and other coding standards are properly integrated into the EMR.
- Set up and maintain payer rules, billing templates, and claim configurations within the EMR system.
- Generate, analyze, and report on program-specific data related to billing and reimbursement trends.
- Monitor metrics such as claim denial rates, reimbursement patterns, billing turnaround times, and payer performance.
- Identify and resolve gaps in billing processes, including EMR-related issues that impact reimbursement.
- Collaborate with IT and clinical staff to streamline billing and documentation workflows.
- Ensure billing workflows and EMR configurations align with federal, state, and payer-specific compliance requirements.
Data Management and Reporting :
Extract, clean, and analyze program data to support billing accuracy and program performance monitoring.Develop and maintain dashboards that highlight key billing metrics and operational efficiency.Provide insights into billing trends and performance to senior management to inform strategic decisions.Collaborate with program managers to align data collection and reporting with billing and revenue cycle objectives.Training and Support :
Provide training to billing and clinical staff on EMR updates, proper documentation, and workflows to improve billing efficiency.Act as a liaison between the billing department, clinical teams, and IT support to address system and operational challenges.Create and maintain user guides and documentation for EMR billing workflows and configurations.Assist in onboarding new staff, ensuring they understand EMR billing processes and compliance requirements.Compliance and Auditing :
Conduct regular audits of billing data, workflows, and documentation to ensure accuracy and compliance with payer and regulatory requirements.Stay updated on industry regulations, payer requirements, and EMR updates to proactively address potential compliance issues.Review claims for coding and documentation errors and work with staff to correct and prevent future occurrences.Assist in preparing for external audits by ensuring data integrity and compliance with regulations.System Optimization and Project Management :
Collaborate with the IT department to implement EMR system updates and enhancements related to billing and revenue cycle management.Identify opportunities to automate manual billing processes within the EMR system.Lead projects to integrate new billing programs, payer contracts, or services into the EMR system.Test new EMR functionalities, updates, and workflows before deployment to ensure alignment with operational needs.Support integration of third-party billing or clearinghouse systems with the EMR to streamline revenue cycle operations.Partner with clinical leadership to align EMR documentation workflows with billing and revenue optimization strategies.Performance Monitoring and Improvement :
Monitor and improve the efficiency of claims submission, processing, and reimbursement workflows.Track and analyze denials, identifying root causes and implementing corrective actions.Ensure accurate charge capture and reconciliation processes for clinical services.Develop and maintain performance benchmarks for billing processes and revenue cycle operations.Additional Responsibilities :
Provide detailed audit documentation for internal and external billing audits as requested.Design and update billing forms and documentation as necessary.Stay current with company policies, payer requirements, and industry trends.Lead biller for special programs and new programs.POSITION REQUIREMENTS
Education and Experience :
High school diploma or GED required; Associate’s or Bachelor’s degree in health administration, business, or related field preferred.Minimum of 3 years of experience in medical billing and revenue cycle management, preferably in an FQHC setting.Experience with ECM and CS program billing is highly desirable.Certified Professional Coder (CPC) certification required.Knowledge, Skills, and Abilities :
Strong understanding of medical, dental, and behavioral health billing and coding, including ICD-10, CPT, and HCPCS codes.Proficiency in electronic health records (EHR) and practice management systems.Excellent analytical skills with the ability to interpret complex billing data and regulations.Detail-oriented with strong organizational and time management skills.Effective communication and interpersonal skills, with the ability to lead and work collaboratively with diverse teams.Maintain strictest confidentiality; adhere to all HIPAA guidelines / regulations.Successful completion and acceptable results of post offer physical examination, proof of COVID 19 Vaccinations and booster, drug screening, and criminal background check.PHYSICAL ACTIVITY
While performing this work, the incumbent :
Will spend substantial time standing, sitting, speaking and listeningMust regularly lift and / or move up to 10 pounds, and occasionally lift and / or move up to 25 poundsIs expected to travel via personal vehicle throughout the community on a frequent basisReasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.
EQUIPMENT & SOFTWARE OPERATION
The incumbent in this position may operate any / all of the following equipment :
Telephone, cell phone, faxComputer, printer and related equipmentCopy machineAudio-visual equipmentPersonal automobileComputer software may include any or all of the following :
Microsoft OfficeMicrosoft AccessDesign / Publishing softwareInternet ExplorerDonor Software
