Neighborhood Health Centers of the Lehigh Valley is currently seeking a Full-Time Medical Billing Manager to provide supervisory oversight and management of all facets of the billing department including claims processing, revenue monitoring and quality improvement initiatives. Works cooperatively with other managers and administration to ensure timely billing, reporting and patient account management.
Responsibilities and Duties
- Performs overall revenue management including: satisfying timely filing requirements and maximizing billing revenue and collections, and resolution of denied/rejected claims.
- Submits claims via the Greenway Clearinghouse. Supervise submission by billing specialists.
- Monitors reports to ensure clean claims submissions.
- Monitors monthly aging reports and conduct follow-up on unpaid claims and take appropriate action to correct and re-bill for reimbursement.
- Identifies, researches and resolves system issues through direct contact with payors and software vendors.
- Provides technical expertise to ensure accurate billing including billing for new services and staying informed of regulatory, compliance, and best practices for FQHC billing.
- Develops, implements, and maintains NHCLV revenue cycle standard operating procedures (SOPs).
- Researches and maintain billing compliance and regulations, primarily for FQHC Medicare and Medicaid.
- Performs regular audits of daily billing reports to identify coding and billing errors. Work with billing clerk and other NHCLV staff to address; notify on-site management of problems and troubleshoot as needed.
- Monitors A/R aging and payment reports monthly to identify trends and underpayments; investigate causes and take appropriate steps toward resolution using professional judgment.
- Provides monthly updates of revenue cycle status including reports, metrics, and presentations. Works with CFO and Staff Accountant as needed to accomplish.
- Works closely with the Practice Management System vendor to identify and work to resolve systemic issues.
- Provides training as required to on-site staff regarding: billing and other revenue cycle related tasks, standard operating procedures (SOPs).
- With other members of the management team, develop continuous process and priorities for quality improvement to improve revenue cycle outcomes.
- Handle and be knowledgeable of all software utilized in the management of operations related revenue for NHCLV, including understanding of pertinent service contracts.
- Maintain professional and technical knowledge by attending educational workshops, and other activities such as: reviewing professional publications; establishing personal networks; participating in professional societies.
- Performs special projects and other duties as requested.
Qualifications and Skills
- A Bachelor’s degree in a business or related field or relevant experience with progressive development of responsibilities.
- Minimum of five years business office management experience; prefer some experience as a department manager.
- Proficiency in use of billing software applications and general MS Office applications.
- Experience working with all types of third party payers. (HMO, PPO, Medicare/Medicaid, etc.) and understanding of FQHC billing requirements.
- Excellent communication and organizational skills.
- Demonstrates accountability, integrity, professionalism, openness, receptive to change, creativity and innovative.
- Bilingual (English/Spanish) written and verbal skills preferred.
NHCLV offers an excellent benefit package including 8 paid holidays, PTO, a competitive pay rate and an excellent benefit package including medical, dental and vision along with company paid Life and a Short Term Disability plan when eligible!
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The Mission of the NHCLV is to provide primary and preventive health and wellness services in the Lehigh Valley, regardless of a person’s ability to pay. We strive to do this directly and in partnership with other organizations, with a goal of creating a primary health care home for an underserved community.
This is not intended to be a full job description.