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FQHC Billing and Financial Services Manager
2 months ago
What You'll Do:
The FQHC Billing & Financial Services Manager is responsible for ensuring maximum effectiveness of Elica’s billing operations. This includes assisting with the development and coordination of implementation initiatives that ensure consistency and quality of the coordination of billing processes, procedures, and best practices for all phases of Elica’s Billing Department. This position oversees Elica’s billing functions including the billing and collections of patient accounts, compliance with third-party payer regulations, cash posting, staff productivity and ongoing improvement to key revenue cycle indicators. These key indicators include but are not limited to: days revenue in A/R, paid claims percentage, managing denied claims, timely billing, clean claims, etc.
The FQHC Billing & Financial Services Manager reports directly to the Controller and collaborates closely with key strategic internal partners within Elica including: CFO/COO, Revenue Cycle Operations Manager, Program & Operations Directors, Process Improvement Engineers, and Site Managers.
Essential Job Functions:
Manage a team of billing and coding specialists, providing guidance, training, and support to ensure accurate and timely billing processes.
Work closely with finance and clinic personnel to optimize billing procedures and address any billing-related concerns. Engage in clear and effective communication with healthcare providers, insurance entities, and patients to manage billing inquiries and resolve disputes promptly
Monitor billing benchmarks and standards of practices with policies and procedures consistent with organizational goals, infrastructure, and federal and state requirements.
Plan and allocate resources to effectively staff and accomplish the work to meet departmental productivity and quality goals.
Monitor billing data and trends, identify improvement areas, and implement solutions to enhance billing performance
Conduct regular audits of billing records to ensure accuracy and compliance with regulatory requirements. Also, the findings should be communicated to appropriate team members.
Develops a system of reporting, dashboards, and key performance indicators to provide meaningful information for appropriate staff.
Consistently explores opportunities for enhancing the execution and assistance of all billing processes and operations.
Manage the accuracy and timely posting of payments, adjustments, and write-offs in EPIC according to Elica’s policy and procedures
Analyze and reconcile financial reports with accounting to ensure accurate, complete, and consistent information.
Maintains required billing records, reports, files.
Assist with coding and error resolution.
Oversee the development, maintenance, implementation, and training of policies, procedures, and workflows for all functions related to billing.
Assist the Billing Managers with internal management of the department staff.
Coach, mentor, and develop staff, including overseeing new employee onboarding and providing career development planning and opportunities.
Stay updated on changes in healthcare billing regulations and requirements, and ensure that billing practices remain in compliance with current standards.
Communicate effectively with healthcare providers, insurance companies, and patients to address billing inquiries and resolve billing disputes.
Intentionally cultivate a workplace culture aligned with the organization's overall mission and values, emphasizing the identified mission and values of the organization.
Carry out any additional responsibilities as required
Requirements
Education and Licensing Requirements:
Bachelor’s Degree required; MBA preferred. Equivalent experience may be considered in place of education requirements.
Minimum 5 years of billing & coding experience within the healthcare industry. FQHC experience is highly preferred.
A minimum of three years of responsible leadership experience in management or supervisory positions overseeing the work of a group of people.
Familiarity with multiple EHRs and Practice Management Systems helpful. Experience with Epic preferred.
Extensive knowledge of Medi-Cal, Medicare, and Managed Care required.
Demonstrable billing experience within the areas of billing, coding, insurance verification, eligibility for benefits, reimbursement, payment posting, denials management, healthcare technology, customer service, counseling, teaching/education, health provider front and back office, and experience with associated online payer systems.
Essential Skills/Abilities:
Ability to foster a spirit of teamwork and unity among department members that allows for disagreement over ideas, conflict and expeditious conflict resolution, and the appreciation of diversity as well as cohesiveness, support, and working effectively together to enable each employee and the department to succeed.
Powerful leadership skills with the ability to coach and mentor teams through periods of high growth
Knowledge and experience in business, supervision, and management.
Knowledge of the functions, operation, and mission of the specific department.
Better than average written and spoken communication skills.
Outstanding interpersonal relationship building and employee coaching and development skills.
Demonstrated ability to serve as a knowledgeable resource to the organization's management team that provides leadership and direction.
Strong computer skills particularly with Microsoft Office (Excel, Word, PowerPoint) and Google Workspace.
Strong analytical skills with the ability to identify trends and present information in a succinct and actionable manner.
Creative problem-solving skills with the ability to multitask and prioritize business requirements in a dynamic, fast-paced environment.
Ability to think and work creatively and effectively in a rapidly changing environment.
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