Executive Caqh Jobs (NOW HIRING)

JOB POSTING:  Accounts Receivable Billing Associate

Full –Time – Monday thru Friday  (8:30 A.M. – 5:00 P.M.)

Reporting Directive: CFO and CEO

Accounts Receivable billing Associates will oversee all aspects of the FQHC’s management of denials, resubmission of claims, collections and payment. The Manager will ensure timely and accurate processing of claims through diligent monitoring and analysis of accounts receivable. Ensuring compliance with financial regulations, implementing strategies to improve cash flow and manage risk associated with outstanding patient/insurance balances.

The candidate must have accounts receivable expertise with New Jersey Medicaid and Medicaid HMOs. Other Insurance Coverage: Medicare, Commercial, and Sliding Fee Program. ICD-10 Coding and the current CPT procedures for a busy primary/specialty care practice. The AR Manager/Credentialing must have extensive knowledge of E&M Coding.

Essential Duties- Accounts Receivable

• Aging Analysis- Regularly analyzing accounts receivable aging reports
• Review of Reports- Software System Claims Portal - Clearinghouse
• Identify Trends, address issues and improve cash flow
• Implement new technologies and process to streamline accounts receivable operations and improve efficiency
• Prepare and analyze financial reports related to accounts receivable
• Monitor aging balances recommend write offs/Bad Debt
• Approval to Write-Off Monthly/Quarterly – CFO/CEO
• Monthly Statistical Report for Uninsured Patients/Population of patients served

• Promotes the exchange of information between the Financial Counseling, Billing Department, Information Technology (IT) and CFO

• Support interdepartmental team building and timely resolution of coding/procedure code deficiencies
• Performs other duties as assigned and required to maintain an efficient and effective workflow

Accounts Receivable Manager Skills

Detail oriented with exceptional problem-solving skills

Excellent oral communication skills

Working Knowledge of Practice Management Billing Systems

Familiarity with Excel Spreadsheets

Ability to prioritize

Accuracy and attention to detail

Greenway Intergy experience is highly valued.

Working knowledge of Microsoft Office products; Excel, Word, and Power Point.

Excellent analytical and interpretive skills.

Prior experience with a FQHC- "Federally Qualified Health Cent

Essential Duties- Credential

• Primary source verification
• Preparation/Completion of Applications for Health Care Providers
• Recertification for providers and facility
• Experience with CAQH- Council for Affordable Health Care
• Knowledge of NPPES/PECOS/NCQA
• Perform monthly queries with National Practitioner Data Bank/OIG
• Maintain/store accurate records for Health Care Providers
• Communication with Insurance Plans- Participation of Providers/Facility
• Maintain Provider Directory for Insurance Plans
• Coordination with Billing and IT Department – NPI numbers
• Interaction with Human Resource Department

Credentialling Skills

Detail oriented with exceptional problem-solving skills  

Excellent oral communication skills

Ability to create manuals, flow charts, dashboard of participation of providers

Coordination with Medical Staff for Hospital Privileges

Education/Experience: 

High school diploma required.

Associate or Bachelor’s degree in Finance/Accounting, Business Management/HealthCare Administration required

3-5-years’ experience working in an accounting, billing/credentialing  or accounts receivable department/Primary Care Practice Setting

Experience with Practice Management Systems -- Intergy/Greenway

Knowledge of  Credentialing process in an FQHC

The following statements reflect the general duties, responsibilities and competencies considered necessary to perform the principal functions of the job and shall not be considered as a detailed description of all work requirements that may be inherent in the position.

Osborn Family Health Center is a Federally Qualified Health Center (FQHC), located in Camden, N.J, Equal Opportunity Employer.