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Junior Revenue Cycle Management Supervisor
2 months ago
Midwest Refuah Health Center is seeking a Junior Medical Billing Supervisor to contribute significantly to our revenue cycle management, compliance, and quality assurance efforts. This role is essential in maintaining the financial health of our healthcare organization, which is on the path to becoming a Federally Qualified Health Center (FQHC). You will be responsible for supervising billing operations, ensuring precise and timely billing, managing provider credentialing and enrollment, and overseeing collections from third-party payers and patients.
Key Responsibilities:
Leadership:
- Direct and oversee all billing staff activities, providing guidance, monitoring performance, and conducting evaluations.
- Facilitate monthly team meetings and audits to ensure operational efficiency.
- Maintain access to clearinghouse and insurance portals.
Billing Operations:
- Evaluate the performance of third-party billing companies.
- Ensure the accurate and prompt processing of claims, including addressing rejected and denied claims.
- Oversee the preparation and submission of electronic billing to fiscal intermediaries.
- Manage write-offs and conduct monthly report reviews.
- Implement updates to billing software and clearinghouse processes.
- Assist with various billing tasks as necessary.
Credentialing Management:
- Review and process applications for healthcare provider credentialing and enrollment with insurance companies and managed care organizations.
- Manage all aspects of provider privileging and credentialing.
- Ensure the accuracy and completeness of application materials in compliance with regulatory standards.
- Maintain up-to-date provider credentialing files in collaboration with relevant stakeholders.
- Communicate with insurance companies and MCOs to resolve credentialing issues.
- Assist in developing and implementing credentialing policies and procedures.
- Work with internal teams to ensure timely credentialing completion.
Patient Financial Support:
- Oversee the patient financial assistance process, ensuring the correct application of the Sliding Fee Discount Scale.
Reporting and Analysis:
- Generate and review electronic patient statement files on a monthly basis.
- Supervise all aspects of billing processes.
- Prepare month-end billing and financial reports.
Compliance and Quality Assurance:
- Implement and revise policies for accurate and timely billing.
- Ensure compliance with governmental billing regulations.
- Investigate and resolve billing discrepancies.
Training and Development:
- Provide training to staff to ensure adherence to procedures and enhance revenue.
- Support Quality and Compliance Departments in addressing patient grievances.
Additional Responsibilities:
- Assist with departmental audits and board meetings as required.
- Perform other assigned duties and collaborate effectively within a teaching organization.
- Assist with referral management and quality improvement initiatives.
- Demonstrate cultural sensitivity and respect for diversity in all interactions.
Qualifications:
- Bachelor's degree in a relevant field or equivalent experience, preferably in healthcare.
- At least 3 years of experience in medical billing, ideally in a primary care environment.
- Supervisory experience is preferred.
- Experience in a Federally Qualified Health Center is a plus.
- AAPC medical billing certification or willingness to obtain within the first year is preferred.
- Familiarity with billing terminology, coding standards, and experience with Medicare, Medicaid, and commercial insurance.
- Proficiency in eClinicalWorks is preferred.
- Strong skills in Microsoft Office and other medical records systems.
- Excellent interpersonal skills with the ability to maintain professionalism in stressful situations.
- Ability to work independently, manage multiple tasks, and prioritize effectively.
- Strong communication skills, both verbal and written.
Midwest Refuah Health Center is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, ethnicity, religion, sexual orientation, veteran status, national origin, pregnancy or related conditions, or disability.