Revenue Cycle Fqhc Jobs (NOW HIRING)

• Responsible for the revenue cycle for assigned accounts
• Manage a team of Billing Specialists and collaborate with the Management team and supported departments to accurately capture reimbursement opportunities
• Promote growth of Team Members through established developmental goals, competencies, guidance, and counseling
• Act as coach, leader, catalyst, and facilitator with Team Members
• Provide analytical, practical, and operational experience with private practice revenue cycle
• Provide direction to team members and organize the billing function to maximize departmental productivity
• Conduct regular productivity analysis and audits for assigned billing team
• Manage department, including problem solving, administering procedures to increase efficiencies, and implementing new systems to ensure accountability
• Review payor denials, making required corrections in billing system(s) by obtaining necessary contract documentation
• Ensure all bills/claims received by billing team are expediently logged, prioritized, and verified according to established policies and procedures
• Ensure billing team follows MMG Billing Policies as well as Client Policies
• Train team on specifics of each contract, changes in policies and procedures, industry or regulatory changes to ensure compliance
• Identify and facilitate problem solving and conflict resolution
• Ensure continual payor maintenance
• Participate in payor reimbursement meetings and/or conferences relating to Medical Billing and Accounts Receivable as requested
• Audit, research, and reconcile setup and required maintenance of the billing system(s) including any payer contract changes
• Generate standard reports, and review each for accuracy and consistency with the billing system(s)
• Communicate and meet with practices to review account activity/issues
• Conduct professional meetings, prepare agendas and provide minutes to meetings
• Analyze accounts MTD/YTD activity and address concerns regularly
• Maintains and ensures compliance to regulatory standards
• Abide by HIPAA standards and requirements
• Monitor monthly cash collections by payor to eliminate potential payor issues.
• Participates in professional development efforts to ensure currency in health care practices and trends.
• Participate in LinkedIn posts and articles.

• High school diploma or equivalent required
• Associate or Bachelor Degree a plus
• Minimum 10 years billing/revenue cycle management experience is required
• Strong knowledge and experience in FQHC (Federally Qualified Healthcare Centers) required
• Advanced knowledge of the healthcare industry and a sound financial background is required
• Clear understanding of billing and collection regulatory guidelines and requirements
• CPT and ICD-9/ICD-10 exposure and experience
• Proficient background in reimbursements
• Knowledge of multiple specialties and ancillary services is required
• Knowledge and experience in monitoring Clearinghouse activity, reports, processes
• Knowledge and experience in setting up payors with EDI, ERA and EFT processes
• Knowledge and experience in startup of a new or established revenue cycle engagements
• High proficiency with computer software including but not limited to insurance websites, Microsoft Office products (Word, Excel, Outlook, Teams)
• Competent with standard office equipment
• Knowledge and experience in developing and manipulating excel reports/pivot tables
• Demonstrated ability to work independently or in a team environment
• Ability to uphold production standards and accountability among direct reports
• Proven ability to train, lead, guide, and direct subordinates is essential
• Organize and prioritize responsibilities while remaining flexible to changing demands
• Ability to react calmly and effectively in high stress or delicate situations
• Excellent written and oral communication skills, interpersonal skills, and an ethical mindset
• Able to analyze complex data and draw conclusions
• Must have high level of discretion and judgment
• Able to make decisions with limited information in a timely fashion
• Utilize a proactive approach to solving problems and willingness to confront and raise issues before they become problems.

Demonstrates extensive experience in revenue cycle management, particularly within Federally Qualified Healthcare Centers (FQHC), with a strong understanding of billing regulations and reimbursement processes. Proven ability to lead and develop teams while ensuring compliance with industry standards and optimizing operational efficiency.

• Revenue Cycle Management
• FQHC Experience
• CPT and ICD-9/ICD-10 Knowledge
• Team Leadership and Development
• Regulatory Compliance

• Billing and Collection Guidelines
• Reimbursement Processes
• Clearinghouse Activity Monitoring
• EDI, ERA, and EFT Setup
• Excel Report Development
• Data Analysis
• Problem Solving
• Productivity Analysis
• Audit and Reconciliation
• Contract Documentation Management

• Interpersonal Skills
• Communication Skills
• Decision-Making
• Flexibility
• Conflict Resolution

• Healthcare Industry
• HIPAA Compliance
• Accounts Receivable
• Medical Billing
• Professional Development

• Microsoft Office Suite
• Insurance Websites
• Billing Systems