Billing Manager; Hybrid

Position Overview

We are seeking a detail-oriented and experienced Billing Manager to join our dynamic team. The Billing Manager is responsible for the daily operations of the insurance department, accounts receivables, billing and providing assistance as needed to the CFO. Responsible for all facets of billing and collecting from all payor sources. Primary contact person for Insurance companies and Clearinghouse Vendor.

The Billing Supervisor may also perform other duties across the organization as their skills and training permit and may be cross‑trained in other areas to accomplish operational objectives. This is a hybrid position with primarily remote work; however, regular or occasional onsite attendance at our facilities will be required based on operational needs.

• Management
  – Determines the most effective method for assigning responsibilities and duties to department employees.
  – Maintains job descriptions, procedures, and other documentation related to the organization of the department.
  – Assigns duties and responsibilities, and ensures employees receive instruction/training needed to complete their job responsibilities.
  – Ensures that employees are aware of and adhere to all company policies and procedures and conveys all senior management communications and directives.
  – Reviews departmental work for thoroughness and accuracy and provides specific instructions to employees on completion of tasks/responsibilities and project deadlines.
  – Develops employees by being a coach and champion, providing support, guidance, and opportunities for growth and advancement.
  – Prepares and conducts performance appraisals for immediate staff.
  – Conducts hiring, disciplinary, and termination procedures for billing staff.
• Billing
  – Oversees end‑to‑end billing and collections processes for medical and behavioral health services within an FQHC environment.
  – Ensures accurate charge capture and timely submission of claims following PPS and encounter billing requirements.
  – Manages Medicaid and Medicare FQHC‑specific billing.
  – Ensures that secondary billing and wrap‑around/encounter billing is occurring on a timely basis.
  – Monitors A/R aging, denial trends, and payer performance.
  – Develop and leads corrective strategies to reduce write‑offs.
  – Supports compliance with sliding fee program rules, including accurate application of discounts and related billing procedures.
  – Develops and maintains standard operating procedures for billing workflows across all service lines.
  – Partners with front desk to ensure accurate insurance verification, sliding fee application, and patient payment collections.
  – Collaborate closely with providers to ensure documentation supports accurate coding and reimbursement.
  – Develops billing department workplan and monitors billing staff resource deployment and productivity.
  – Participates in negotiation of payer contracts and independently analyzes and ensures that CHC is receiving all reimbursements owed to them under the contracts.
  – Collaborates closesly with HR on new provider credentialing to ensure that provider enrollment with all payers is completed timely.
• Compliance and Reporting
  – Ensures all billing practices comply with HRSA, HHS, CMS, Medicaid, and payer‑specific regulations.
  – Documents periodic coding and sliding fee audits and provides results to the Compliance Officer and key management staff as appropriate.
  – Maintains readiness for HRSA OSV audits, Medicare/Medicaid program reviews, and annual cost reporting.
  – Follows all internal policies related to billing and collections.
  – Collaborates with finance, operations, and clinical teams to ensure accuracy in billing‑related components of the Uniform Data System (UDS) report.
  – Provides monthly revenue cycle performance metrics to leadership.
• Education/
  
  Experience:
  
  – Possesses advanced general skills, including written and verbal communications skills, computational and computer skills, and mathematical knowledge frequently acquired through completion of a general Bachelor’s Degree program or an Associate’s degree with acquired business experience.
  – Must know all aspects of the trade as it is…