As a Federally Qualified Health Center, Outside In provides 28,000 medical and behavioral health visits a year to the most vulnerable members of our community. The Medical Billing Manager is responsible for directing and coordinating the overall functions of the medical, mental health, substance abuse, and alternative medicine billing and coding in compliance with the philosophy, policies, procedures, goals, and budget of Outside In.
This position is 40 hours a week, with full medical and dental benefits and 27 paid days off in the first year. The salary range is $45,000 - $55,000. The application deadline is 3/31/17.
- Requires strong managerial, leadership, and business office skills, including critical thinking and the ability to produce and present detailed billing activity reports.
- Evaluate accounts receivable reports to analyze revenue and payment trends.
- Develop and implement projects including, but not limited to, patient volume capture, billing process improvement and regulatory compliance to achieve health center goals.
- Complete quality assurance routines and supervise billing team; assess staffing patterns and performance issues recommending changes as needed and work with employees to develop departmental and individual goals.
- Track payment of the reimbursement methodologies to ensure they are in compliance with Medicaid, Medicare, commercial insurance, and HMO collections.
- Stay current with legal and regulatory changes in coding & billing and analyze, quantify and communicate reimbursement trends on a state and national level.
- Assist in the preparation of various mandatory reports.
- Maintain information on managed care contracts, keeping current on requirements and changes and ensuring reimbursement is followed per agreement with each individual plan.
- Educate staff, including providers and clinical staff, on payer specific policies and general coding guidelines.
- Research possible implementation of the Alternative Payer Method.
- Work in multiple electronic health record systems, OCHIN/Epic, Centricity, and Credible.
- 2+ years of progressive management and medical reimbursement experience.
- Certified coder is a plus.
- Knowledge of FQHC regulatory requirements, health care delivery standards, policies and procedures.
- Thorough working knowledge of CPT and ICD-9 and ICD-10 coding protocols and procedures, along with advanced skills in Microsoft Excel.
- Well-versed with all federal, state and HIPAA privacy regulations.
- Knowledge of medical necessity rules and procedures impacting claim submission, denials and insurance reimbursement.
- Prior experience with an electronic medical record system required.
- Excellent written and oral communication skills with the ability to provide clear, concise directives.
- Ability to deliver results on multiple projects at the same time.