About the role
- Oversee billing department operations including charge processing, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management
- Provide direct support to supervisory staff, mentor and coach staff, and develop training tools
- Ensure billing operations follow Federal, State, and payer regulations, guidelines, and requirements
- Spearhead payor projects and resolve complex billing issues, discrepancies, and claim denials
- Review and interpret operational data; design and implement systems to enhance revenue and operating efficiency
- Develop and implement standard operating policies and procedures
- Supervise billing office personnel including work allocation, training, and coordination of time off
- Prepare, analyze, and present accounts receivable and daily/weekly/monthly financial reports; monitor KPIs, SLAs, and productivity
- Audit procedures to monitor and improve efficiency of billing and collections operations
- Analyze trends impacting charges, coding, collection, and accounts receivable and realign staff and revise policies as needed
- Keep up to date with carrier rule changes and distribute information; perform physician credentialing actions
- Contribute to internal process documentation, training materials, and maintain library of documentation guidelines and coding
Requirements
- Associate's degree preferred 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
- Minimum of 3 years medical insurance/healthcare billing and collections experience in a medical practice or health system
- FQHC, or Experience with Community Health Centers – Required
- Two years’ supervisory or management experience
- Familiarity with credentialing and other health center operations
- Medical coding/industry-related certification a plus
- Experience working in ECW, Athena, Nextgen
- Advanced proficiency in RCM software and Microsoft Office Suite
- Data analytics and process improvement experience
- Strong communication, negotiation, and interpersonal skills
- Ability to work independently and as part of a collaborative team
- Detail-oriented with exceptional problem-solving abilities
- Ability to set and maintain priorities in a fast-paced client-focused environment
- Ability to monitor team performance and make adjustments as needed
- Fully Remote (CA)
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ATS Keywords
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Hard skills
billing operationscharge processingclaims submissionspayment postingaccounts receivablereimbursement managementmedical codingdata analyticsprocess improvementfinancial reporting
Soft skills
communicationnegotiationinterpersonal skillsproblem-solvingdetail-orientedindependent workteam collaborationsupervisory skillsmentoringtraining development
Certifications
medical coding certification