Fqhc Billing Supervisor

Job Title: FQHC Billing Supervisor

Salary:Starting at $70k/year DOE

Location: Tustin - On-site

Openings: 1 Position Available

Position Purpose:

Responsible for timely and accurate billing claim submission to responsible third party payers. Responsible for monitoring and development of Business Office billing staff. Assures compliance with Medicare, Medi-Cal, Commercial Insurances, Federal and State Laws impacting health care. Monitors and creates edits in the electronic billing system to achieve accurate high clean claim ratios. Coordinates office efforts and works closely with Recovery Supervisor to expedite collections.

Key Responsibilities: Oversees the day to day billing functions for all billing staff, including tracking goals and ensuring P & P's are followed, and coordinating office efforts to expedite payment of accounts.

Core Duties and responsibilities, include but are not limited to:

• Supervises Billing Department staff on tasks associated with billing and collection from third party payers. Monitors billing processes of billing staff to assure that billing is correct and timely.

• Ensures that all required information is attached to every billing form, TAR.

• Ensures timely submission and acceptance of claims to all payers.

• Elevates issues with payers and reports improvement as appropriate.

• Assists the PFS Director and Recovery Supervisor. Performs designated duties when they are absent.

• Assists with the implementation of quality and performance improvement measures for the business office.

• Participates in the development of unit policies and procedures

• Must be capable of performing all tasks required of hourly billing and collection employees.

• Identifies accounts not selected for billing (ANSB). Reviews system generated billing, collections and medical records abstracting reports to monitor weekly collections, billed and unbilled accounts.

• Identifies and collects on underpaid accounts.· Recommends future course of action based on data interpretation and recommends system changes, as appropriate.

• Reviews Claims Edit List to monitor specific issues, as well as recurring issues and resolution.

• Communicates issues that are preventing timely and accurate billings to appropriate hospital department Manager for performance improvement process.

• Uses a wide variety of communication formats to keep staff regularly informed and trained with one to one and team meetings.

• Serves as a resource to staff by answering questions, assisting with problems, and providing training as necessary.

• Ensures appropriate and professional communication with payers and patients.

• Reviews and resolves issues related to claim generations, clean claim ratios, rejected, denied billings. Determines the accuracy of charge capture, missing charges, late charges, covered and non-covered charges.

• Other duties as assigned but within scope

• This job description in no way states or implies that these are the only duties to be performed by the employee. He or she will be required to follow any other instructions and to perform other duties, within scope, as assigned by his or her supervisor.

Qualifications, Skills, and Experience:

• Bachelor's degree in Health, Accounting, or related field. Certification/license in medical billing or coding.
• Minimum of two (3) years of supervisory billing experience required, preferably in an FQHC setting.
• At least two years of knowledge and experience working with Federally Qualified Health Centers (FQHCs) preferred.
• Advanced knowledge of Excel is preferred.
• Strong oral and written communication skills.
• Ability to work independently and manage critical tasks under deadlines.
• Knowledge and experience with Medicare, Medi-Cal, insurance plans, contract payers, and government entities.

Families Together of Orange County (FTOC) is proud to be an equal opportunity employer. FTOC does not discriminate based on race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, disability, ancestry, marital status, veteran status, medical condition, or any protected category prohibited by local, state or federal laws.