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Medical Billing & Collections Manager

Posted 2 years ago in Healthcare



The person who fills this position will plan, direct and coordinate all activities of the billing department. S/he will support the organization through daily management of the billing staff responsible for medical and dental, hospital inpatient, and special programs billing. S/he will also manage the billing and collection/denials management processes for all clients and third party payers.

We are seeking an efficient, process-driven individual with strong leadership skills and a desire to drive improvements; strong experience and knowledge in managing electronic billing processes a participative management style advocating team concept who is results and profit oriented with the ability to balance other business considerations; must have the ability to establish credibility and be decisive,and be able to recognize and support the organization’s preferences and priorities; The person who fills this position will have excellent problem-solving, organizational, time management and interpersonal skills and a strong ability to create a comfortable, supportive learning environment. This person also needs advanced knowledge of practice management systems (preferably NextGen) and Excel.

Some of the essential job functions for this position are:
  • Perform full range of supervisory duties for all billing staff
  • Be responsible for setting work expectations for the billing staff related to insurance claims, patient balances, delinquent accounts, and payment posting.
  • Monitor completion of daily deposits, reconciliation of daily activity, timely claims submittal and patient statement processes
  • Monitor and manage Accounts Receivable trends, including Days Outstanding, cash receipts, bad debt, and AR trends
  • Work with clinic staff to monitor and manage Denials Management trends
  • Monitor, train and adhere to payer regulations, including strong knowledge of Medicare, Medi-Cal, and FQHC regulations
  • Maintain department policies, procedures and training program
  • Act as active member of the Revenue Cycle team, developing and implementing revenue management strategies
  • Implement feedback mechanisms for resolutions of most frequent/costly denials in a timely manner to improve billing efficiency and cash flow
  • Ensure that the charge capture process functions efficiently, that all charges are captured and submitted completely, timely, and accurately.
  • Implement and monitor coding issues and trends from payer sources, system, and overall needs of the department
  • Oversee electronic claim submission, monitor problems that arise, communicate and resolve issues with software vendor
  • Coordinate NextGen end of month closing
  • Develop and maintain a strong working relationship between Billing and Operations departments
  • implement systems to audit billings and posting of payments, collections and denials, to ensure accuracy of accounts receivable, timely visit adjudication, and revenue maximization
  • Review all Payer Contracts and Contract Amendments (including Medicaid, Medicare, Managed Care Plans); set up and revise procedures as necessary
  • Participate in and emphasize patient centered medical home processes

Minimum Qualifications:
High school graduate or equivalent with minimum 5 years healthcare/medical experience; 4 years experience with billing fee-for-service payers including Medicare and HMO programs; minimum 3 years supervisory experience gained through increasingly responsible management positions; valid driver’s license and vehicle insurance, and reliable transportation. Preferred are a Bachelor’s degree in business or related healthcare field; CPC credentialing and previous experience in a medical or healthcare clinic, FQHC

About Vista Community Clinic:

Vista Community Clinic is a private, non-profit medical, dental and social services center providing health care in a comprehensive, high quality setting. We provide the highest quality services in five different locations throughout Vista and Oceanside. We are looking for dedicated, motivated, enthusiastic team players who want to serve our population.

VCC provides quality health care and health education to the community focusing on those facing economic, social or cultural barriers.

If you are selected for this position, you will make a difference in the lives of others. Every day, you will make an impact on your community.

We have a very competitive compensation and benefits programs which includes health, dental, vision, company-paid life, AD&D & disability insurance, flexible spending accounts and a 403(B) plan.

Visit our website at www.vistacommunityclinic.org, for more information about our many excellent programs and activities.

Vista Community Clinic is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, status as a protected veteran, among other things, or status as a qualified individual with a disability.

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