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Chw Revenue Cycle Management Billing
4 months ago
**Coastal Health & Wellness **is Galveston County’s Community Health Center, with clinics in Texas City and Galveston. We also service TCISD students and employees. First established in 1970 and then called Galveston County Coordinated Community Clinics (4C’s), we provide high quality healthcare to all - offering primary care, prenatal, dental, and behavioral health counseling services.
RCM provides task-based coding, billing, and collection support to CHW and various Galveston County Health District (GCHD) partners. This includes standard, highly reliable, team-oriented, daily work with payors including Medicare, Medicaid, Medicaid Managed Care, Commercial Insurance as well as County Indigent and Self-pay patients in NextGen EPM/EHR/EDR.
The **CHW** **Revenue Cycle Management Billing & Coding Manager** will have financial and operational accountability over CHW’s revenue capture system, including but not limited to, claims, coding, prior authorization, verification of benefits, accounts receivable, and all other revenue cycle operations. This individual will provide leadership, administration, supervision, organization, planning and direction over all activities of the Revenue Cycle to ensure accomplishment of the organization's objectives leading CHW medical, dental, and behavioral health billing and coding functions for all outpatient professional services to ensure its compliance, accuracy, and timely submission for payment. Additionally, they are accountable for the planning, development, deployment and maintenance of a highly reliable coding audit and education program via coaching of staff, physicians, nurses, and other departments. This leader serves as the principal liaison with The Board, providers, executive team, and managers related to day-to-day medical, dental and behavioral health RCM activities. The CHW RCM team is responsible for compliant, comprehensive, and critical work in areas including but not limited to medical, dental and/or behavioral health pre-authorization, eligibility & benefits, coding, claims submission, A/R follow-up, payment posting & reconciliation, denial management and customer service.
**We can offer you**:
- Excellent Benefits; including an Amazing retirement package, Paid Time Off plans, Affordable Medical Insurance, FREE Life Insurance, FREE Long-Term Disability, FREE Parking and much more
- Team Oriented Environment
- Salary Rate: $62,400.00 actual offer will be commensurate upon related experience & education
**We want you to join our team of professionals **If you meet the criteria listed below, please apply.
**Required**:
- Certifications:
- Certified Professional Coder (CPC) required.
- Certified Professional Medical Auditor (CPMA), Certified Medical Office Manager (CMOM), Certified Professional Biller (CPB), preferred.
- Certified Documentation Expert Outpatient (CDEO) or Certified Risk Adjustment Coder (CRC) a plus.
- Bachelor’s Degree plus a minimum of five (5) years of coding experience in private physician and/or FQHC organization to include three (3) years coding supervisory/management progressive leadership experience.
- Proven ability in coding compliance program development, deployment, and oversight.
- Knowledge of coding/billing regulatory requirements.
- Excellent interpersonal, presentation and written communication skills.
- Bilingual in Spanish preferred.
- NextGen EPM, EHR, EDR experience is preferred.
- Strong leader who intentionally invests in the development of others and identifies/closes knowledge gaps.
- Capable & competent time management and multi-tasking acumen.
- Understanding of medical terminology and coding & billing compliance laws, regulations, policies, and guidelines.
- Customer experience-oriented professional with demonstrated performance history and commitment.
- Advanced skills Microsoft suite of products; Outlook, MS Office (MS Excel & MS Word) - SharePoint experience a plus.
- Must be compliant with GCHD Immunizations policy and ICS training requirements.
- Must pass criminal background check and drug/alcohol screening.
- Must be willing and able to work evening and weekend hours, as necessary.
- Must possess or ability to readily obtain a valid driver’s license issued by the State of Texas for the type of vehicle or equipment operated.
- Department of Motor Vehicle check may be required, if applicable.
- An equivalent combination of education and work experience which appropriately demonstrates the knowledge, skills and abilities to perform the above described essential functions will be considered when hiring for this role._
**Traditional Duties**:
- Direct supervision of RCM Supervisor.
- Provides direction and manages the day-to-day functions within the RCM team which include medical, dental, and behavioral health encounters for uninsured as well as claims with all payors including Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies.
- Manages staffing plans and work ass
