A growing and dynamic health center is looking for a Junior Medical Billing Supervisor to play a crucial role in ensuring effective revenue cycle management, compliance, and quality standards within our healthcare organization, which is working toward becoming an FQHC. You will oversee all activities and staff in the billing function, ensure timely and accurate billing, oversee provider credentialing and enrollment, and manage the collection process from third-party payors and patients. You will develop and implement policies and procedures, coordinate staff, maintain accurate medical record information, achieve revenue targets, and optimize patient financial interaction. The incumbent will play a crucial role in ensuring the accurate and timely credentialing of healthcare providers with insurance companies and managed care organizations (MCOs).
Specific Responsibilities and Duties:
Supervision:
- Supervise all activities and staff in the billing function, provide direction, monitor work, coach, and conduct performance management.
- Conduct monthly staff meetings and audits.
- Maintain clearinghouse and insurance portal access.
Billing Processes:
- Monitor 3rd party billing company performance
- Ensure accurate and timely processing of claims, correction of rejected and denied claims.
- Oversee the preparation and submission of electronic billing to fiscal intermediaries.
- Manage write-offs and review reports monthly.
- Implement billing software and clearinghouse changes, maintaining up-to-date information.
- Assist in all billing processes, as needed
Credentialing:
- Review and process credentialing and enrollment applications for healthcare providers with insurance companies and MCOs
- Own all aspects of provider privileging, credentialing, and enrollment
- Verify the accuracy and completeness of application materials, ensuring compliance with regulatory standards and organizational policies
- Maintain accurate and up-to-date provider credentialing files in conjunction with key stakeholders or contractors
- Communicate with insurance companies, MCOs, and other stakeholders to resolve credentialing and enrollment issues and inquiries
- Assist in the development and implementation of credentialing and privileging policies and procedures
- Collaborate with internal teams, including revenue cycle and operations teams, to ensure timely completion of credentialing processes
Patient Financial Advocacy:
- Oversee the patient financial aid process, ensuring accurate application of the Sliding Fee Discount Scale.
Reports and Analysis:
- Generate, review, and submit electronic patient statement files monthly.
- Oversee all aspects of billing processes.
- Prepare billing and financial reports for month-end.
Compliance and Quality:
- Implement and revise policies and procedures for timely and accurate billing.
- Ensure current billing practices comply with governmental rules and regulations.
- Investigate and resolve billing discrepancies and errors.
Training and Development:
- Provide staff training and development to ensure compliance with procedures, increase revenue, and maintain a successful patient experience.
- Support Quality and Compliance Departments with patient grievances and resolution.
Additional Duties:
- Assist with departmental audits.
- Board meetings as needed.
- Perform other duties as assigned
- Collaborate, teach, and function effectively in a teaching organization.
- Assist with referral management, medical record requests, and quality improvement and assurance activities, as needed.
- Demonstrate cultural sensitivity and respect for diversity.
Qualifications:
- Bachelor’s degree in a related field or equivalent experience, preferably in healthcare.
- Minimum of 3 years of experience in medical billing, preferably in a primary care setting.
- experience in a supervisory role overseeing staff preferred
- Experience working within an FQHC is preferred.
- AAPC medical billing certification, or willingness to complete in firstyear is preferred
- Knowledge of billing terminology, coding standards, and experience with Medicare, Illinois Medicaid, Commercial Insurance, online systems, and Explanations of Benefits.
- Proficiency in eClinicalWorks preferred
- Proficiency in Microsoft Office and other billing or medical records systems.
- Strong interpersonal skills; ability to maintain a calm, professional manner in stressful situations.
- Ability to work independently, handle multiple tasks, set priorities, and accomplish job responsibilities.
- Ability to effectively communicate via telephone, computer, and in person.
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. While performing the duties of this job, the employee is regularly required to talk or hear, sit, use hands, reach with hands and arms, stand, walk, walk up and down stairs, lift and/or move up to 25 pounds.