Mgr FQHC Billing & Revenue Integrity-Ar Management (Prof)

About the role

Maintains the integrity of the revenue capture system across the Federally Qualified Health Centers (FQHC) Locations. Focuses on the maximization of collections through the accurate and complete capture of all charges as well as the implementation and maintenance of charge capture processes. Works closely with clinical departments to align processes with government, payer, and internal charge capture policies; provides education to the clinical departments. Utilizes knowledge of governmental and third-party payer regulations, billing, and reimbursement processes. Assists in coordinating and overseeing all activities related to collections and accounts receivable management. Ensures all activities related to collection functions include, but are not limited to; claim status, denial management, aged account follow up and resolution for Patient Financial Services are coordinated with other revenue management functions to meet customer requirements, maximize revenue collection and achieve best practice targets.

Responsibilities

• Maintains the integrity of the revenue capture system across the Federally Qualified Health Centers (FQHC) Locations.
• Focuses on the maximization of collections through the accurate and complete capture of all charges as well as the implementation and maintenance of charge capture processes.
• Works closely with clinical departments to align processes with government, payer, and internal charge capture policies; provides education to the clinical departments.
• Utilizes knowledge of governmental and third-party payer regulations, billing, and reimbursement processes.
• Affords assistance in coordinating and overseeing all activities related to collections and accounts receivable management.
• Ensures all activities related to collection functions include, but are not limited to; claim status, denial management, aged account follow up and resolution for Patient Financial Services are coordinated with other revenue management functions to meet customer requirements, maximize revenue collection and achieve best practice targets.

Requirements

• Required Bachelor’s Degree, preferably in Accounting, Finance or Healthcare Management. In lieu of a Bachelor Degree, will accept Certified Professional Coder (CPC).
• 4 years of demonstrated experience with EPIC and/or major industry standard billing system.
• Financial analytical experience in a healthcare environment.
• Demonstrated experience with FQHC Revenue Cycle Operations.
• Demonstrated knowledge of healthcare revenue cycle practices.
• Demonstrated ability to manipulate and analyze data derived from disparate source systems.
• Advanced knowledge of MS Excel, Access, PowerPoint and query tools to create reports and financial models.
• Excellent time management and project prioritization skills with ability to multi-task.
• Detail oriented with demonstrated ability to work independently.
• Good written and verbal communication and interpersonal skills.
• Ability to facilitate group meetings and interview sessions.
• Must be knowledgeable in all third-party billing requirements and Coordination of Benefits (COB).
• Analytical aptitude and ability to translate functional needs to an integrated technical/professional computerized environment.

Qualifications

• Preferred Progressive management experience.
• MBA/MPH/MHA/MHS or other certification such as CPA.
• Certification in billing and coding represented by any of the following: RHIA, RHIT, RN, CPC, COC, CCS, or CCS-P
• High level of quantitative and qualitative research, analytical skills and critical thinking skills with expertise to drive process development to implementation.