PAYER RELATIONS FQHC Billing Manager
Location: Biloxi, MS, 39530
Base Pay: $45000.00 - $52000.00 / Year
Employee Type: Regular Full Tim, M-F, 8:00am – 5:00pm
Description: This is skilled work in the field of health care contracting and claims coding. The position will review and negotiate contracts with all payers to maximize revenue and provide support to the Revenue Cycle department in resolving payer issues. This position is required to review all payer quality incentive program requirements and develop coding guidance to allow more efficient methods for capturing accurate reporting data to maximize incentive revenues. This position will also work closely with finance, quality management and corporate compliance staff to develop reports necessary for grant reporting, including UDS and Medicare Cost Report.
Knowledge, Skills, and Abilities
Knowledge of third-party billing practices and procedures.
Knowledge of medical office practices and procedures.
Knowledge of data processing.
Knowledge of the importance of maintaining Protected Health Information (PHI) records; able to maintain confidentiality under current Health Insurance Portability and Accountability Act (HIPAA) laws and regulations.
Ability to navigate Electronic Health Records (EHR), Electronic Practice Management (EPM) and other automated data processing systems.
Ability to perform job duties in an effective and timely manner with minimal supervision.
Ability to organize and use time and resources effectively.
Ability to effectively organize and maintain files.
Ability to follow oral and written instructions timely and accurately.
Ability to work and communicate effectively with patients, providers, co-workers, and the general public.
Ability to respond effectively, efficiently, and personably to staff and patient inquiries.
Ability to function as an effective and productive team member.
Ability to travel to other sites, as needed.
Ability to exercise a high degree of diplomacy and tact; excellent customer services and interpersonal communication skills; cultural sensitivity and demonstrated ability to work with diverse groups/staff members.
Must be able to sit, stand, bend, lift, and move intermittently during the workday.
Qualifications/Education Requirements
High school diploma or GED certificate required. Experience with NextGen Electronic Health Record and Electronic Practice Management Minimum five years of experience in medical billing and coding. Experience in payer contracts negotiation. 2 years of leadership experience.
Core Competencies
Develop and maintain ongoing collaborative relationships with payers.
Review payer contracts to ensure fair and equitable terms consistent with services provided.
Serve as a member of committees as needed, including HIT, OPIT, Risk Management, Compliance and Special populations.
Assist in root cause analysis of denial trends and work with payers on claims projects to maximize revenue.
Review value-based incentive programs and work with quality staff to configure EHR system to help capture data.
Develop policies/procedures to enhance coding of services to capture quality data efficiently to maximize incentive revenue.
Provides technical and billing assistance to staff.
Communicates with staff, patients, and intermediaries on changes in billing and coding requirements.
Assists HIT Trainers with electronic practice management and billing requests.
Competent in basic computer skills, including spreadsheets and business letters.
Competent in basic math, including calculation of ratios and percentages.
Upholds, complies with, and enforces the Core Principles and Code of Conduct
