Billing Manager – Federally Qualified Healthcare Center

Billing Manager – Federally Qualified Healthcare Center Description

Billing Manager – Federally Qualified Healthcare Center

• Compensation:
• $72,000.00 – $81,000.00
• City, State:
• Req’d Qualifications:
• Bachelor Degree in Business Administration, Health Care Administration or related field

We are partnered with a federally qualified healthcare center with locations across Los Angeles, Riverside, & San Bernardino counties to help them find a Billing Manager. This role will be performed out of their corporate office located in Downtown Los Angeles.

You will be responsible for ensuring that patient billing and processing of payment receipts are consistently completed timely and in accordance with policy, as well as provide leadership to a team of 8 billers/coders.

Their mission is to minimize disparities in healthcare access and outcomes by providing superior-quality, patient-centered healthcare. They provide a variety of services in medically underserved areas such as: primary care, preventative care, minor emergency services, and some specialty services including dental care. As an organization, they take immediate and effective action to remedy all health-related challenges, whether it is a physical ailment or a mental diagnosis.

Responsibilities:

· Supervise and evaluate assigned support staff in a timely manner. This position will supervise billers, coders, and any other assigned staff

· Ensure accuracy of deposits, demographic and other information entered into the patient billing system.

· Participate in program/service evaluation activities; facilitate changes in provision of service based on Continuous Quality Improvement results.

· Compile and prepare various status reports for management in order to analyze trends and make recommendations.

· Participate in preparation of annual UDS report.

· Monitor data integrity for the practice management system. Report problems to the CFO or other appropriate personnel in a timely manner.

· Monitor volume of charge and collection posting on a monthly basis to confirm that billers are keeping up with patient encounter volume. Recommend and/or implement changes to work schedule, as needed, when work flow in the Billing Department is significantly behind.

· Responsible for ensuring the timeliness of processing and correction of rejected claims.

· Maintain rosters of Managed Care patients for all plans which have been active within the two most recent calendar years.

· Maintain regular schedule for sending out billing statements in accordance with the Financial Policies and Procedures.

· Maintain and process for review of all billing statements which are returned to sender. Utilize public records and other resources to make best effort to obtain accurate billing addresses.

· Maintain a regular schedule for writing off bad debts, including a process which requires and documents attempts to collect or resubmit prior to removing the charge from outstanding receivables. Submit Bad Debt Write Off Report to CFO.

· Monitor coding practices among providers to determine potential patterns of under coding or other irregularities.

· Keep billers and coders up to date on third party coverage contracts, assuring that current contractual terms are understood and applied correctly.

· Establish and maintain a regular process for follow up on patient accounts which are pending approval for third party coverage.

· Maintain current information for billing and collections processes for each third party carrier in a Billing Manual. Ensure fee schedule for third party payors is maintained and up to date

· Train relevant staff (front office, patient navigators, and enrollment specialists) to identify uninsured patients who may qualify for Medi-Cal, Family Pact, CHDP, or other programs which can cover some or all charges.

· Maintain process for verifying insurance at the time of each billable patient encounter.

· Monitor and identify any patterns in remittance advices which would indicate the front desk staff are not properly collecting insurance information. In coordination with Clinic Managers/Site Supervisors, initiate retraining and/or other corrective action indicated.

· Coordinate the Revenue Cycle (Patient Business Services) team to address any deficiencies in staff performance uncovered by internal audits.

· Must hold all patient Protected Health Information (PHI) and other patient personal information and agency information in confidence, in accordance with the Employee Confidentiality Statement, which you have read, understand and signed.

· Participate in CQI, other internal committees, special projects/observances or activities that promote improvements in organizational performance and/or advance the mission, goals and objectives of CNHF.

· Coordinate with the Chief Information Officer to ensure the development and implementation of data information systems and business technology solutions, which accurately and efficiently compile, record, and report revenue cycle and financial data.

Requirements:

· Bachelor Degree in Business Administration, Health Care Administration or related field is preferred

· 2+ years of experience with billing in the healthcare setting

· ICD-10 medical coding certification preferred