Medical Billing Manager

Medical Billing SupervisorUnder the general direction of the Chief Financial Officer, manages the day-to-day supervision and processes associated with the medical billing function, including outsourced services. Responsible for ensuring the accurate and timely billing and collection of medical claims by monitoring and managing the Revenue Cycle Management (RCM) process.Ensures billing and collection processes meet the organization's financial and operational goals, as well as the requirements for internal controls and third-party payors. Ensures billing and collection processes are compliant with state, local, and federal laws; regulations; and/or best practices. Reviews and oversees the submission of Center for Medicare and Medicaid Services (CMS-1500), also known as Health Care Financing Administration (HCFA), claims to the appropriate health plans weekly. Reviews claims denials for complexity and instructs appropriate staff to make changes and corrections to resubmit claims within 30 days of the denial received date. Performs quality control procedures on all claim forms and detail bills to ensure accurate billing. Verifies insurance benefits and contacts vendors regarding denials or benefit coverage. Runs all required billing reports. Maintains appropriate staffing levels for RCM processes. Updates annual clinic rate changes to Medicaid and Medicare Prospective Payment Systems. Develops and implements systems, mechanisms, controls, and reporting tools to monitor and ensure billing and collection efforts are functioning efficiently. Develops and maintains positive working relationships with patients, contractors, vendors, third-party payor resources, and related entities. Performs fee schedule analysis, rate setting, and maintenance. Loads and maintains procedure and diagnosis codes and performs related research as required. Researches new technologies and tools, recommending improvements to existing processes and supporting ongoing improvement of billing and collection efforts. Researches RCM clinical and grant programs to identify new programs or changes to existing programs. Assists administration in designing programs in the Practice Management Software (PMS). Supervises personnel, managing productivity, work assignments, and process improvement. Serves as a liaison for any outsourced RCM services. Performs related work as required.Bachelor's degree in Healthcare Administration, Business, Accounting, Finance, or a closely related field. Three years of management experience in revenue cycle management, including experience in billing and collections. An equivalent combination of training and experience may be substituted as determined applicable by Civil Service. Responds to patient and FHC needs via telephone, internet, fax, computer software, and in person. Lifts and carries materials weighing up to 15 lbs. Spends extended periods of time sitting, typing, and reading computer screens. Must be available to work extended hours, including before or after regularly scheduled hours and weekends, as necessary. Must provide own transportation to work at other locations as needed.An Equal Opportunity Employer. Training & Experience: 100%.