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Billing Manager - FQHC

Billing Manager - FQHC

MedusindOrlando, FL, US
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Job Description

Job Description

Description :

Medusind is a leading provider of revenue cycle management solutions to medical, dental, behavioral health, anesthesia, pathology, emergency, surgery, radiology, and other specialties. In January 2023, Alpine Investors, a people-driven private equity firm, invested in Medusind to continue to advance its leadership position as one of the top revenue cycle management companies in the country.

The Billing Manager is responsible for the overall oversight of the supervisory staff while ensuring that the billing and collection department is meeting KPI deliverable for its clients. This means that they should have a solid knowledge about all the functions specific to RCM department including but limited to the ones that have direct impact on revenue optimization. The Ideal candidate for this role will have experience in Community Health Centers including but not limited to FQHC, RRHC, IHS and look-alikes. Key responsibilities include providing direct support to the supervisory staff, ability to problem solve complex challenges, mentoring and coaching staff, developing training tools as needed, supporting the month-end process, involvement in the financial reporting of KPIs, and implementing process improvements to scale the expansion of the department.

Key Responsibilities :

Operations :

  • Oversee the operations of the billing department encompassing charge processing, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management, working to reduce outstanding balances and improve cash flow for clients.
  • Serve as the practice expert and work closely with the supervisors to understand and develop strategies to improve overall RCM process.
  • Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are following Federal, State, and payer regulations, guidelines, and requirements.
  • Spearhead payor projects, resolving complex billing issues, discrepancies, and claim denials.
  • Reviews and interprets operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency.

Leadership & Development :

  • Provides, oversees, and / or coordinates the provision of training for new and existing billing staff on applicable operating policies, protocols, systems and procedures, standards, and techniques.
  • Develop and implement standard operating policies and procedures.
  • Supervise billing office personnel, which includes work allocation, training, and being available for staff needs; motivates employees to achieve peak productivity and performance
  • Coordinates team member time off in a manner that does not negatively impact necessary daily functions.
  • Reporting and Analytics :

  • Prepare, analyze and present accounts receivable reports, and daily, weekly, and monthly financial reports.
  • Monitor KPIs, SLAs, month-to-date targets, and productivity. Present findings to management on a daily, weekly, monthly, and quarterly basis.
  • Audit current procedures to monitor and improve efficiency of billing and collections operations.
  • Analyze trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures.
  • Continuous Improvement :

  • Keep up to date with carrier rule changes and distribute the information within the practice.
  • Perform physician credentialing actions.
  • Understands and remains updated with current coding and billing regulations and compliance requirements.
  • Contribute to internal process documentation and training materials.
  • Maintains library of information / tools related to documentation guidelines and coding.
  • Requirements : Education :

  • Associate's degree, preferably in business administration or related field; bachelor’s degree preferred. 5+ years of medical insurance / healthcare revenue cycle experience will be considered in lieu of the degree.
  • Experience :

  • Minimum of 3 years medical insurance / healthcare billing and collections experience in a medical practice or health system, with a deep understanding of medical billing rules and regulations.
  • Familiarity with credentialing, and other health center operations.
  • FQHC, or Experience with Community Health Centers – Required.
  • Two years’ supervisory or management experience.
  • Medical coding / industry-related certification a plus
  • Experience working in ECW, Athena, Nextgen.
  • Communication & Collaboration :

  • Strong communication, negotiation, and interpersonal skills. Ability to work independently and as part of a collaborative team.
  • Detail-Oriented :

  • Exceptional problem-solving abilities and attention to detail to ensure accuracy in billing.
  • Ability to set and maintain priorities in a fast-paced client-focused environment, with multiple demands and interruptions.
  • Collaborative Problem Solving :

  • Ability to work and communicate effectively with a diverse group of people including other department managers, staff, physicians, patients, etc.
  • Technical skills :

  • Advanced proficiency in RCM software and Microsoft Office Suite, data analytics, and process improvement initiatives. Leveraging technology and automation to enhance efficiency and accuracy.
  • Adaptability and flexibility :

  • Should be able to adapt to changes in regulations, technologies, and industry trends and adjust the revenue cycle management strategy accordingly.
  • Performance Management :

  • Ability to monitor team performance and make adjustments as needed to improve team and individual performance.
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