Billing Manager (Administrative)

JOB SUMMARY
The Billing Manager oversees the day-to-day operational billing process, ensuring accurate billing and timely collections while managing the billing team to optimize revenue cycle operations. This role involves coordinating with various departments to resolve billing discrepancies and improve overall efficiency in revenue cycle management.
JOB DUTIES AND RESPONSIBILITIES

Manage and oversee billing staff and operational activities to ensure optimal performance. This duty encompasses medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.
Maintain an effective organizational structure, including schedules and staffing, to achieve departmental goals and objectives.
Collaborate with supervisor to identify issues, evaluate workflow processes, and enhance efficiencies across billing, other departments, third-party payers, and vendors.
Provide strategic direction, set priorities, and analyze revenue cycle activities to drive improvements.
Recommend, develop, and implement new and revised policies and procedures in collaboration with the Senior Director of Revenue Cycle Integrity and/or CFO.
Monitor and resolve billing discrepancies and address patient inquiries promptly and professionally.
Analyze revenue cycle performance metrics and industry key performance indicators (KPIs) to identify opportunities for enhancement.
Ensure timely processing and posting of charges, payments, refunds, and adjustments.
Assist in month-end closing processes to ensure accuracy and completeness.
Assist in maintaining payer/provider structure with NextGen to support billing requirements as needed.
Assist with validating NextGen configuration and testing patches or upgrades.
Attend meetings at the request of the Senior Director of Revenue Cycle Integrity, contributing insights and updates.
Support the development and management of the departmental budget.
Uphold confidentiality regarding patient account status and sensitive information.
Assist with hiring, training, and mentoring billing staff to foster a high-performing team.
Perform other duties as assigned to support departmental and organizational objectives.

KNOWLEDGE, SKILLS, AND ABILITIES

In-depth knowledge of Medicare and Managed Care Medi-Cal billing within the Federally Qualified Health Center (FQHC) environment.
Familiarity with third-party payer rules and regulations.
Comprehensive understanding of state and federal regulatory billing requirements.
Proficient in electronic billing processes, including knowledge of clearinghouses and 5010 EDI requirements.
Competency in relevant technology, including practice management systems and applications.
Advanced proficiency in Microsoft Office Suite, particularly Excel.
Strong collaboration skills to engage effectively with management and staff across departments.
Excellent written and verbal communication abilities, capable of motivating others and conveying complex information clearly and concisely; skilled in preparing and presenting diverse reports and analyses.
Strong organizational and time-management skills, with a focus on prioritizing tasks effectively.
Exceptional attention to detail, ensuring accuracy in all aspects of work.
Proven ability to work as part of a team while also functioning independently to meet tight deadlines.

EDUCATION & EXPERIENCE

Associate degree, preferably in Business Administration or related field; Bachelor's degree preferred. 5+ years of related work experience will be considered in lieu of degree requirement.
CPC (Certified Professional Coder) or CCS (Certified Coding Specialist)
Prior Experience as a Manager, Supervisor, or Lead.

PREFERRED QUALIFICATIONS

Experience working in NextGen Practice Management software
Experience in Federally Qualified Health Center patient billing operations
RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator)
NCP (Certified NextGen Professional)

BENEFITS
SCHC understands the importance of good health for every employee. We offer a comprehensive benefits package to ensure employees and their families receive the optimal in health care coverage, along with options to meet their needs.

Competitive wages
Medical insurance
Dental insurance
Vision insurance
403(b) retirement plan with matching employer contribution
Long-term disability coverage
Life insurance
Accidental death and dismemberment insurance
Supplemental Insurances
Flexible spending account
Paid vacation
Paid sick
Paid holidays
Paid CME time and CME allowance
Employee assistance program
Jury duty pay
Bereavement pay
Prescription discount program
529 college savings plan
Educational reimbursement program
Gym membership discounts
Free subscription based app for meditation and sleep
Free telemedicine service for benefit eligible employees