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About The Position
Optimus Health Care, the largest provider of primary health care services in Fairfield County, is seeking an experienced Billing Manager to join their team onsite in Stratford. The FQHC (Federally Qualified Health Center) Billing Manager will oversee all aspects of the billing process, including managing billing staff, ensuring regulatory compliance, and optimizing revenue cycle management. This role involves working with the Director of Revenue Cycle to establish effective claims management, improve billing and collections efficiency, and ensure key performance metrics are met or exceeded. The position requires a strong understanding of medical billing and coding, FQHC regulations, and proficiency in billing software and EHR systems, with EPIC preferred. A Bachelor’s degree in healthcare administration, business, or a related field is preferred, along with a minimum of 5 years of medical billing experience and 2-3 years in a supervisory or management role. Experience in an FQHC or similar healthcare setting is highly preferred. Bilingual English/Spanish skills are a plus, and certifications like CCA, CPB, CMRS, or CPC are desirable.
Requirements
- Minimum of five years’ of billing experience
- 2-3 years’ in a Supervisory role
- Strong understanding of medical billing and coding practices.
- Knowledge of FQHC billing requirements and regulations.
- Excellent leadership and team management skills.
- Proficiency in billing software and electronic health records (EHR) systems; EPIC preferred
- Strong analytical and problem-solving abilities.
- Excellent communication and interpersonal skills.
- Demonstrated ability to analyze complex problems and to arrive at sound decisions or recommendations.
- Knowledge of financial reporting in a community healthcare environment and to effectively operate within budget constraints.
- Must be able to work a flexible schedule when required
- Minimum of 5 years of experience in medical billing
- At least 2-3 years in a supervisory or management role.
- Experience working in an FQHC or similar healthcare setting is highly preferred.
Nice To Haves
- Bachelor’s degree in healthcare administration, business, or a related field preferred.
- Bi-lingual English/Spanish is helpful but not required.
- CCA, CPB, CMRS or CPC certification desirable
Responsibilities
- Oversee the daily operations of the billing department, ensuring accurate and timely submission of claims.
- Monitor billing processes for compliance with federal, state, and local regulations.
- Implement and maintain billing policies and procedures to optimize efficiency and effectiveness.
- Assist with the development and implementation of strategies to improve revenue cycle performance.
- Analyze and report on key performance indicators (KPIs) related to billing and collections.
- Identify and resolve issues related to claim denials, rejections, and underpayments.
- Supervise and mentor billing staff, providing guidance and training.
- Conduct performance evaluations and address performance issues.
- Ensure the billing team stays updated on changes in billing regulations and practices.
- Ensure all billing practices comply with applicable laws and regulations, including HIPAA.
- Conduct regular audits of billing activities to identify and correct errors.
- Collaborate with the compliance officer to address compliance issues.
- Oversee the implementation and maintenance of billing software and systems.
- Work with IT staff to troubleshoot and resolve system issues.
- Ensure data integrity and security within billing systems.
- Collaborate with clinical, compliance, administration, and finance departments.
- Assist financial management with quarterly and annual financial reporting of billing and receivable data.
- Assist in creating data to support non-Medicaid contracts, IRS990, and other reports.
- Communicate regularly with management regarding billing issues, challenges, and performance.
- Participate in management meetings and contribute to strategic planning.
- Address patient inquiries and concerns related to billing.
- Ensure patient billing statements are accurate and understandable.
- Implement processes to enhance patient satisfaction with billing services.
Benefits
- Excellent health & welfare benefit options
- Competitive Compensation
