Billing Manager

Fair Haven Community Health Care 

FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at nearly 130,000 office visits in 17 locations. Overseen by a Board of Directors, the majority of whom are patients themselves, we are proud to offer a wide range of primary and specialty care services, as well as evidence-based patient programs to educate patients in healthy lifestyle choices. As we grow and are able to bring high-quality health care to more areas that need access, we continue to put our patients first in everything we do. The mission of FHCHC is “To improve the health and social well-being of the communities we serve through equitable, high quality, patient-centered care that is culturally responsive.”

For over 50 years, we have been a health care leader in our community focused on providing excellent, affordable primary care to all patients, regardless of insurance status or ability to pay. Fair Haven is proud to have a diverse and motivated team of professionals who are constantly seeking ways to enhance and improve the health and well-being of all patients. We believe that everyone should have access to high-quality medical and dental care, regardless of ability to pay.

Job purpose

Reporting to the Sr. Director of Operations, the Medical Billing Manager will oversee all functions of Fair Haven’s Medical Billing Department to maximize revenues, provide analysis, create written processes and provide training and education efforts of the department.

Duties and responsibilities

The Medical Billing Manager will direct and manage the daily operation of the departmental billing office to ensure the preparation; posting and collections of all billable encounters are completed in an accurate and timely manner. The successful candidate will supervise and facilitate all processes, policies, procedures and be responsible for overall team motivation and effectiveness.

Typical duties include but are not limited to:

• Manages transitions to changing billing and coding environments as they occur through each payor source including Medicaid, Medicare, Commercial, and Private Pay.  Trains billing and clinical staff in use of new codes and establishes new processes to accommodate changes as needed to maintain efficient workflow and uninterrupted collections.
• Maintains current information on Third Party Payors, including thorough knowledge of ICD-10 and CPT codes, and keeps staff informed of insurance provisions & changes.
• Ensures that current fee schedules and billing manuals are being used for all payers billed while adhering to all organizational billing policies and procedures.
• Develops monitoring and tracking systems for billing (e.g. claim rejection) and provides detailed bi-weekly reports.
• Oversees monthly audits of for departmental efficiency and accuracy related to medical coding and payment accuracy and integrity.
• Monitor aged accounts bi-monthly working with staff to address oversights or problems within payers. Ensure staff follow the process to work unpaid claims and backlogs (i.e. credentialing and carrier issues) are reported to be managed promptly assuring appeals are done in a timely manner. Reviews established accounts for bad debt write off.
• Assists the Controller with the monthly accounting close of patient revenues by analyzing billing activity
• Maintains EHR super user status including active participation in user groups, upgrades and staff training as needed.
• Ensures patient confidentiality, and provides patients with needed information as requested
• Hires new billing staff as necessary and completes performance evaluations as required by FHCHC policy.
• Develop and maintains training processes for both new hires and existing staff
• Reviews and recommends updates to FHCHC Billing Policies bi-annually, and as necessary.
• Participates in team meetings both internally and externally as assigned.

Qualifications

Baccalaureate degree and five years of experience in an ambulatory care or practice management setting, including experience in a supervisory capacity is required. A Certified Professional Coding (CPC) certificate and proficiency in billing and finances or the willingness to get certified within the first 90 days of employment is also required.

A combination of education and appropriate experience may be substituted for the degree requirement.

Knowledge of medical, behavioral health and dental is essential.  Knowledge and proven experience in non-profit Federally Qualified Health Centers is strongly preferred.

Direction of Others

Directly supervises, Medical Billing Coders including Lead, Medical Billing Specialists, Dental Billing Specialist, Behavior Health Billing Specialist

We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.