medical billing manager

Quorum Services

<div><div><b>Revenue Cycle Manager &ndash; EMS Medical Services Billing &amp; Collections</b><br>
</div><div><b>About Us</b><br>
</div><div>Capstone Transportation is a leadership company that happens to provide medical transportation services. We are actively seeking future leaders who are driven to grow, inspire others, and make a lasting impact. This position is ideal for individuals who are passionate about healthcare operations and enjoy improving financial performance while supporting exceptional patient care.</div>
<div></div><div>Since 2015, Capstone Transportation and its affiliated operations have provided communities with compassionate non-emergency and emergency medical transportation services. We foster an entrepreneurial culture of ownership coupled with a field-driven structure that empowers local leaders and their teams to provide superior solutions to the unique transportation needs of the communities they serve. As our organization continues to grow across multiple states, we remain committed to innovation, operational excellence, safety, and exceptional service.</div>
<div></div><div>Working closely with healthcare facilities, insurers, patients, and community partners, our mission is to ensure every patient receives safe, reliable, and compassionate transportation services while maintaining the highest standards of operational and financial performance. u</div>
<div>________________________________________</div>
<div><b>Position Overview</b></div>
<div>With our continued growth, we are seeking a highly skilled and proactive <b>Revenue Cycle Manager</b> with extensive experience in <b>EMS Medical Services Billing, Accounts Receivable Management, and Revenue Cycle Operations.</b><br>
</div><div>This individual will play a critical role in optimizing AR performance by leading billing, collections, denial management, and reimbursement processes across multiple operations. The Accounts Receivable Leader will partner with Business Office Managers, Operational Leaders, Accounts Receivable experts in other business lines, and Accounting Partners to drive process improvements, ensure regulatory compliance, maximize reimbursements, and improve cash collections.<br>
</div><div>This role is ideal for a strategic thinker with deep expertise in ambulance and medical transportation billing, Medicare and Medicaid reimbursement methodologies, payer relations, and revenue cycle management. The successful candidate will thrive in a collaborative environment and be passionate about developing people, improving processes, and producing measurable financial results.<br>
</div><div>This is a full-time, hybrid position with travel required to support field-based operations.</div>
<div>________________________________________</div>
<div><b>Job Summary</b></div>
<div>The primary purpose of this position is to direct, train, and support Business Office Managers, Billing Specialists &amp; Executive Directors in the accurate and efficient billing and collection of EMS and medical transportation claims in accordance with company policies, payer requirements, and industry regulations.</div>
<div>This leader will oversee accounts receivable performance, drive timely collections, improve reimbursement outcomes, strengthen revenue cycle processes, and ensure the accurate recording of revenue transactions across multiple operating locations.</div>
<div></div><div>The ideal candidate will actively demonstrate and promote Capstone Transportation's Core Values:</div>
<ul><li><b> </b><b>C</b>ustomer Second</li></ul>
<ul><li><b> </b><b>A</b>ccountability</li></ul>
<ul><li><b> </b><b>P</b>assion for Learning</li></ul>
<ul><li><b> </b><b>L</b>ove One Another</li></ul>
<ul><li><b> </b><b>I</b>ntelligent Risk Taking</li></ul>
<ul><li><b> </b><b>C</b>elebration</li></ul>
<ul><li><b> </b><b>O</b>wnership</li></ul>
<div>________________________________________</div>
<div><b>Essential Duties &amp; Responsibilities</b></div>
<div></div><div><b>Revenue Cycle &amp; Billing Operations</b></div>
<ul><li> Oversee EMS and medical transportation billing operations across multiple locations.</li></ul>
<ul><li> Monitor claim submission, payment posting, denials, and collections to ensure optimal reimbursement.</li></ul>
<ul><li> Ensure billing workflows are compliant with Medicare, Medicaid, commercial insurance, managed care, and private-pay requirements.</li></ul>
<ul><li> Review aging reports and collection performance to identify improvement opportunities.</li></ul>
<ul><li> Partner with operations and billing teams to reduce outstanding AR and improve cash flow.</li></ul>
<ul><li> Ensure best practice processes in place for private collections.</li></ul>
<ul><li> Lead initiatives focused on clean claim submission and first-pass resolution rates.</li></ul>
<div>________________________________________</div>
<div><b>System Management</b></div>
<ul><li> Ensure billing and AR systems are accurately configured with current fee schedules, payer requirements, and workflows.</li></ul>
<ul><li> Monitor system updates and regulatory changes and implement necessary adjustments.</li></ul>
<ul><li> Maintain reporting functionality and data integrity.</li></ul>
<ul><li> Work with vendors and internal stakeholders to resolve billing system issues and improve operational efficiency.</li></ul>
<div>________________________________________</div>
<div><b>Regulatory Awareness &amp; Compliance</b></div>
<ul><li> Stay informed on EMS, ambulance transportation, and healthcare reimbursement regulations.</li></ul>
<ul><li> Assess organizational readiness for regulatory and payer changes.</li></ul>
<ul><li> Ensure compliance with Medicare, Medicaid, HIPAA, and commercial payer billing requirements.</li></ul>
<ul><li> Act as a liaison between operations, compliance, and revenue cycle teams.</li></ul>
<div>________________________________________</div>
<div><b>Process Improvement</b></div>
<ul><li> Evaluate and improve denial management, appeals, collections, and reimbursement processes.</li></ul>
<ul><li> Develop strategies to accelerate collections and reduce AR days outstanding.</li></ul>
<ul><li> Identify opportunities to increase reimbursement accuracy and reduce claim rejections.</li></ul>
<ul><li> Explore technology-driven and AI-enabled solutions to streamline workflows and improve productivity.</li></ul>
<ul><li> Lead continuous improvement initiatives across revenue cycle operations.</li></ul>
<div>________________________________________</div>
<div><b>Reporting &amp; Analytics</b></div>
<ul><li> Develop and refine AR performance metrics and KPIs.</li></ul>
<ul><li> Analyze collection trends, denial patterns, and reimbursement data.</li></ul>
<ul><li> Share actionable insights with operational and executive leadership.</li></ul>
<ul><li> Utilize analytics to identify strategic opportunities for process improvement and revenue growth.</li></ul>
<ul><li> Prepare regular reporting packages on AR performance and collection effectiveness.</li></ul>
<div>________________________________________</div>
<div><b>Payer &amp; Contract Oversight</b></div>
<ul><li> Ensure payer contracts, fee schedules, and reimbursement methodologies are accurately maintained within billing systems.</li></ul>
<ul><li> Support contract analysis and reimbursement validation efforts.</li></ul>
<ul><li> Collaborate with leadership regarding payer opportunities and reimbursement challenges.</li></ul>
<ul><li> Monitor payment accuracy against contracted rates.</li></ul>
<div>________________________________________</div>
<div><b>Internal Controls &amp; Audit Functions</b></div>
<ul><li> Conduct audits to verify billing completeness, compliance, and reimbursement accuracy.</li></ul>
<ul><li> Evaluate revenue cycle controls and implement corrective actions where needed.</li></ul>
<ul><li> Ensure documentation standards support billing compliance and payment recovery.</li></ul>
<ul><li> Maintain ownership of revenue cycle compliance initiatives and audit readiness.</li></ul>
<div>________________________________________</div>
<div><b>Leadership, Training &amp; Development</b></div>
<ul><li> Provide ongoing coaching, education, and support to accounts receivable and billing teams.</li></ul>
<ul><li> Develop training materials and facilitate educational sessions on billing and collection best practices.</li></ul>
<ul><li> Mentor operational and business office leaders in revenue cycle management.</li></ul>
<ul><li> Foster a culture of accountability, continuous learning, and operational excellence.</li></ul>
<div>________________________________________</div>
<div><b>Collaboration</b></div>
<ul><li> Serve as a trusted advisor to Executive Directors, Business Office Managers, and AR teams.</li></ul>
<ul><li> Attend market, resource and operational meetings as requested.</li></ul>
<ul><li> Support hiring, performance management, and development of AR and billing personnel.</li></ul>
<ul><li> Communicate best practices across operations and promote consistency in revenue cycle performance.</li></ul>
<div>________________________________________</div>
<div><b>Qualifications</b></div>
<ul><li> Minimum 5 years of progressive experience in Accounts Receivable, Medical Billing, or Revenue Cycle Management required.</li></ul>
<ul><li> Minimum 3 years of leadership experience overseeing billing, collections, or revenue cycle teams preferred.</li></ul>
<ul><li> Strong experience with EMS, ambulance transportation, medical transportation, or healthcare services billing required.</li></ul>
<ul><li> Extensive knowledge of Medicare, Medicaid, managed care, commercial insurance, and private-pay reimbursement.</li></ul>
<ul><li> Proven ability to lead process improvement initiatives and achieve measurable collection results.</li></ul>
<ul><li> Strong analytical, organizational, and communication skills.</li></ul>
<ul><li> Experience with AR reporting tools, KPI dashboards, and revenue cycle analytics.</li></ul>
<ul><li> Demonstrated ability to manage multiple priorities across several operating locations.</li></ul>
<div>________________________________________</div>
<div><b>Preferred Skills</b></div>
<ul><li> Experience with ambulance or EMS billing platforms.</li></ul>
<ul><li> Strong understanding of ambulance fee schedules, transportation modifiers, and medical necessity documentation.</li></ul>
<ul><li> Experience in a multi-location healthcare or transportation environment.</li></ul>
<ul><li> Ability to mentor, train, and develop high-performing teams.</li></ul>
<ul><li> Strong knowledge of healthcare compliance, billing regulations, and audit processes.</li></ul>
<ul><li> Experience leading remote and field-based teams.</li></ul>
<ul><li> Advanced Excel and reporting capabilities.</li></ul>
<div>________________________________________</div>
<div><b>Job Details</b></div>
<ul><li> Full-time.</li></ul>
<ul><li> Hybrid (remote with periodic on-site support and travel).</li></ul>
<ul><li> Position is field-based and requires travel to assigned operations.</li></ul>
<ul><li> Travel may include overnight and out-of-state visits.</li></ul>
<ul><li> Subject to frequent interruptions and changing priorities.</li></ul>
<ul><li> May require work beyond normal business hours, including occasional weekends and holidays, as necessary.</li></ul>
<ul><li> Competitive compensation based on experience.</li></ul>
<ul><li> Opportunity to join a growing organization dedicated to leadership development, operational excellence, and exceptional patient service.</li></ul></div>

Revenue Cycle Manager

Centrum Health

<div><div><p><b>WHO WE ARE</b></p>
<p>
NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.</p>
<p>
NeueHealth delivers clinical care to health consumers through our owned clinics &ndash; Centrum Health and Premier Medical &ndash; as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.</p></div><p>
The Manager of Revenue Cycle Management oversees revenue cycle operations across Centrum's medical centers, including Ponsol and Neighborhood Health, ensuring accurate reimbursement, regulatory compliance, and financial integrity across Medicare Advantage, ACA/Exchange, and Medicaid lines of business. This role is responsible for the back-end revenue cycle, including claims adjudication, denial management, appeals, payment posting, accounts receivable, and reimbursement reconciliation.</p>
<p>
The Manager develops and oversees revenue cycle processes to ensure timely claim resolution, accurate payment posting, effective accounts receivable management, and compliance with CMS, state Medicaid, HIPAA, and payer-specific requirements. The role also manages the fee-for-service (FFS) billing vendor, monitors performance against established standards, and implements controls to ensure claims and payments are accurately processed and reconciled.</p>
<p>
Working in partnership with Finance, Operations, Medical Coding, and Medical Auditing, the Manager drives revenue integrity initiatives, supports clean-claim performance, improves reimbursement outcomes, oversees revenue cycle education for clinic leadership, and ensures effective collection of copays and point-of-service balances. This position also resolves complex payer and patient billing issues and performs other duties as assigned in support of departmental and organizational financial performance</p>
<div>
<p><b>SCOPE OF WORK</b></p>
</div>
<p><i>This position carries revenue cycle responsibility across all Centrum centers (including Ponsol and Neighborhood Health), with primary ownership of the post-submission cycle, and is expected to operate cross-functionally and flexibly as organizational needs evolve. The scope of the role includes, but is not limited to, the following:</i></p>
<ul>
<li>Monitor and manage the revenue cycle once claims leave the door &mdash; tracking rejections, denials, appeals, and payment posting through to resolution.</li>
<li>Manage, monitor, and reconcile the fee-for-service (FFS) billing vendor to ensure submissions, payments, and performance meet contractual and internal expectations.</li>
<li>Monitor and improve charge capture processes in partnership with Coding, Operations, and Clinical leadership.</li>
<li>Implement and maintain a proactive management system to ensure payments are posted accurately and on time and that no claim goes unworked.</li>
<li>Oversee revenue-cycle training for the medical centers and ensure processes are correct, consistent, and compliant.</li>
<li>Work closely with Finance and center managers to ensure copays and point-of-service balances are collected.</li>
<li>Safeguard revenue integrity &mdash; ensuring charges, codes, and claims are complete, accurate, and compliant across all centers.</li>
<li>Assume additional tasks, projects, and responsibilities as needed to support leadership and enterprise priorities.</li></ul><div><br>
<p>
</p><p><b>ESSENTIAL JOB FUNCTIONS</b></p>
</div>
<p><i>The following responsibilities are representative of the work performed in this role. Other duties may be assigned as organizational needs and regulatory requirements evolve.</i></p>
<p><b>
Revenue Cycle Operations &amp; Oversight</b></p>
<ul>
<li>Direct revenue cycle operations with primary ownership of the post-submission cycle: claim rejections, denials, appeals, payment posting, and accounts receivable.</li>
<li>Monitor claims from submission through adjudication and payment, resolving rejections and denials promptly to minimize revenue leakage.</li>
<li>Oversee accounts receivable, ensuring timely collection, follow-up, and resolution of outstanding balances and billing disputes.</li>
<li>Develop, implement, and maintain revenue-cycle policies and procedures to ensure accuracy, consistency, and efficiency.</li>
<li>Establish, monitor, and improve revenue cycle performance metrics including denial rates, clean claim rates, accounts receivable aging, reimbursement accuracy, and cash collections.</li>
</ul>
<p><b>Denials, Rejections &amp; Payment Posting</b></p>
<ul>
<li>Analyze rejection and denial trends, identify root causes, and implement corrective actions and prevention strategies.</li>
<li>Ensure accurate and timely posting of payments, adjustments, and remittances (ERA/EOB), maintaining a proactive monitoring system so no payment is missed.</li>
<li>Reconcile expected versus actual reimbursement and resolve variances.</li>
<li>Develop and implement denial prevention strategies by identifying root causes and partnering with operational stakeholders to improve first-pass claim acceptance.</li>
</ul>
<p><b>FFS Vendor Management &amp; Reconciliation</b></p>
<ul>
<li>Manage and monitor the fee-for-service (FFS) billing vendor, including performance, service levels, and issue resolution.</li>
<li>Conduct regular reconciliation of vendor submissions and payments against internal records and contractual expectations.</li>
<li>Hold the vendor accountable to agreed KPIs, turnaround standards, and reporting requirements.</li>
</ul>
<p><b>Compliance &amp; Revenue Integrity</b></p>
<ul>
<li>Ensure revenue-cycle processes are consistent, correct, and compliant with CMS, state Medicaid, HIPAA, and payer-specific guidelines.</li>
<li>Safeguard revenue integrity across all centers and lines of business, ensuring charges, codes, and claims are complete and accurate.</li>
<li>Stay informed of industry trends and regulatory/payer updates, implementing necessary changes promptly.</li>
<li>Perform and coordinate regular reviews and audits of billing records to ensure accuracy and compliance.</li>
</ul>
<p><b>Collections &amp; Center Partnership</b></p>
<ul>
<li>Partner with Finance and center managers to ensure copays and point-of-service balances are consistently collected at the centers.</li>
<li>Align front-desk and back-office workflows across centers with revenue-cycle best practices.</li>
</ul>
<p><b>Training &amp; Team Leadership</b></p>
<ul>
<li>Oversee and deliver revenue-cycle training for the medical centers, maintaining high standards and up-to-date knowledge.</li>
<li>Supervise and manage the revenue-cycle / billing team, including hiring, training, coaching, and performance evaluations.</li>
<li>Foster a culture of accountability, service excellence, and continuous improvement.</li>
</ul>
<p><b>Cross-Functional Collaboration</b></p>
<ul>
<li>Collaborate with Finance, Operations, Patient Services, and center leadership to streamline workflows and improve communication.</li>
<li>Partner with the Manager of Medical Coding and the Manager of Medical Auditing to align coding accuracy with clean-claim submission and reimbursement integrity.</li>
<li>Manage vendor relationships, including clearinghouses and billing-software providers, to ensure effective service delivery.</li>
</ul>
<p><b>Reporting &amp; Analytics</b></p>
<ul>
<li>Prepare and present regular reports on billing activity, accounts receivable, denials, and financial performance to senior leadership.</li>
<li>Build and maintain trackers, dashboards, and executive-facing presentations in Microsoft Excel (pivot tables, formulas, large-dataset analysis) and Microsoft PowerPoint.</li>
<li>Use data analytics to identify trends, quantify financial impact, and drive process improvement.</li>
</ul>
<p><b>Proactivity &amp; Other Duties</b></p>
<ul>
<li>Anticipate and adapt to changes in payer policy, regulation, and reimbursement models, proactively adjusting processes and procedures.</li>
<li>Address and resolve escalated billing issues and complex payer or patient disputes.</li>
<li>Assume additional responsibilities and cross-functional tasks as needed, and perform other duties as assigned by the Director of Coding &amp; Billing.</li></ul><div><br>
<p>
</p><p><b>QUALIFICATIONS</b></p>
</div>
<p><i>To perform this job successfully, an individual must meet the following qualifications. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.</i></p>
<p><b>
Certifications &amp; Licensure</b></p>
<p><b>
Required</b></p>
<ul>
<li>Certified Revenue Cycle Representative (CRCR)</li>
<li>Equivalent revenue cycle experience may substitute for certification</li>
<li>Active certification must be maintained in good standing through AAPC, AHIMA, HFMA, or an equivalent credentialing body, including required continuing education units (CEUs).</li>
</ul>
<p><b>Preferred</b></p>
<ul>
<li>Certified Professional Coder (CPC)</li>
<li>Certified Risk Adjustment Coder (CRC)</li>
<li>Certified Professional Medical Auditor (CPMA)</li>
<li>Certified Documentation Expert Outpatient (CDEO)</li>
</ul>
<p><b>Education &amp; Experience</b></p>
<ul>
<li>Minimum of five (5) years' experience in billing or revenue cycle management, with at least two (2) years in a supervisory role.</li>
<li>Bachelor's degree preferred; equivalent combination of education and experience considered.</li>
<li>Strong knowledge of billing software and electronic health record (EHR) systems.</li>
<li>Familiarity with CMS guidelines and payer-specific billing requirements.</li>
<li>Experience with Medicare Advantage, ACA/Exchange, and Medicaid revenue cycle preferred; FFS billing and vendor-management experience strongly preferred.</li>
</ul>
<p><b>Knowledge</b></p>
<ul>
<li>Strong knowledge of the full revenue cycle &mdash; charge capture, claim submission, rejections/denials, payment posting, accounts receivable, and reconciliation.</li>
<li>Working knowledge of ICD-10-CM, CPT, and HCPCS as they relate to clean claims and revenue integrity.</li>
<li>Familiarity with clearinghouses, ERA/remittance processing, and practice-management / billing systems.</li>
</ul>
<p><b>Language Skills</b></p>
<ul>
<li>Bilingual proficiency in English and Spanish preferred.</li>
<li>Strong written and verbal communication skills, with the ability to interpret and explain procedural documents and policies effectively.</li>
</ul>
<p><b>Mathematical Skills</b></p>
<ul>
<li>Proficiency in calculating percentages, adjustments, and account balances accurately.</li>
<li>Ability to analyze financial data to reconcile discrepancies and identify areas for improvement.</li>
</ul>
<p><b>Reasoning Ability</b></p>
<ul>
<li>Strong problem-solving skills and the ability to apply sound judgment to standardized and complex situations.</li>
<li>Capable of making decisions that positively impact team performance and organizational goals.</li>
</ul>
<p><b>Other Skills &amp; Abilities</b></p>
<ul>
<li>Advanced proficiency in Microsoft Excel (pivot tables, formulas, and data analysis) and Microsoft PowerPoint (executive-level presentations), with strong working proficiency in Word and Outlook.</li>
<li>Experience with practice-management and billing software.</li>
<li>Strong time-management skills with the ability to manage multiple priorities effectively.</li>
<li>Demonstrates professionalism, initiative, and a commitment to continuous improvement.</li>
<li>Ability to work effectively in a culturally and professionally diverse environment.</li>
<li>Maintains up-to-date knowledge of federal, state, and local compliance standards.</li>
</ul><div><div>As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of NeueHealth, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.</div></div></div>

Manager, Revenue Cycle Management

Summit Surgery Center At Galena

<p>Billing Supervisor needed for a large, busy surgical practice who performs supervisory and administrative work involving billing and collections. He/She will be responsible for insuring claims are submitted timely and properly, helping staff with denials and appeals, reviewing patient/insurance refunds and adjustments as well as monitoring and controlling account aging. He/she will directly manage approximately 15 employees while overseeing all aspects of billing and the daily operations of the department. Candidate must have a minimum of five years billing experience and a minimum of two years as a department manager and have a strong working knowledge of all billing processes and procedures. Ideal candidate will be able to problem solve and have a great attention to detail and make recommendations for process improvements. Candidate must have excellent customer service skills, be solution oriented and can manage a team of employees. Ideal candidate will have EMR experience, familiar with Athena is preferred. Mon-Fri. Excellent benefit package offered.</p><p>Job Type: Full-time</p><p>Pay: $62,000.00 - $67,000.00 per year</p><p>Work Location: In person</p>

Medical Billing Supervisor

UF Health

<div>Overview:
<div><b>
Job Duties</b></div><div>
Under limited supervision, the Lead Physician Billing Compliance Analyst (Lead) will perform physician<br>
coding/documentation reviews for providers of the University of Florida Jacksonville Physicians Group (UFJPI). Audit focus<br>
will be on physician/non-physician practitioner coding and chart documentation to include review of E&amp;M, CPT-4, ICD-10,<br>
Level II HCPCs, Teaching Physician guidelines and carrier specific policies. The Lead will prepare and present accurate<br>
reports of audit findings to appropriate personnel. The Lead will coordinate with various UFJPI representatives to ensure<br>
that any resulting refunds are processed and educational needs are addressed. The Lead will assist the Manager with<br>
monitoring and recording of productivity and quality of staff and will train staff on job duties and work flow processes. The<br>
Lead will ensure all job duties are covered when personnel are on vacation or ill. The Lead will handle routine personnel<br>
issues and act as the liaison between the Manager and Office of Compliance (OOC) staff.</div>
Responsibilities:
<div><b>
Essential Functions</b></div><ul><li>Perform audit reviews of medical providers of the UFJPI within designated timeframes.</li><li>Identify ongoing problems in audit process and notify manager when issues surface.</li><li>Audit chart documentation for accurate coding and to verify that chart documentation supports services billed.</li><li>Audit chart documentation for compliance with E&amp;M, CPT procedure coding, ICD-10-CM diagnosis coding, Teaching Physician guidelines, payer specific polices and regulatory requirements.</li><li>Prepare accurate audit reports that include summary spreadsheets of audit findings.</li><li>Perform analysis of audit findings and summarize by individual records for placement in the OOC central database. Present audit results to appropriate faculty and billing personnel.</li><li>Identify remedial training needs through audit process and if necessary conduct remedial training with provider or billing staff.</li><li>Identify, locate and obtain medical record documentation necessary to accurately complete audits.</li><li>Perform quality assessments on work product of Analysts and Research Assistants in accordance with departmental policies and procedures.</li><li>Assist in the development of policies and procedures to ensure work is performed and completed in accordance with the University of Florida College of Medicine Billing Compliance Plan</li><li>All other duties as assigned</li><li>Travel up to 10%</li></ul>
Qualifications:
<div><b>
Experience Requirements</b></div><div>
2 years Medical billing required<br>
5 years Medical coding (procedural and diagnosis) for multi-specialty providers required<br>
4 years Medicare, Medicaid, and Tricare payment and reimbursement rules required<br>
4 years Medical record chart auditing for professional billing required<br>
1 year Supervisory or project management required<br>
1 year medical management information systems (EPIC preferred) required<br>
1 year Auditing software applications (e.g MDaudit, Compliance Risk Analyzer) preferred<br>
<b>Education
</b></div><div>High School Diploma or GED equivalent required<br>
Associates Business or Health care related field preferred<br>
<b>Certificate/Licensure
</b></div><div>Certified Coding Specialist required or at time of hire<br>
Certified Coding Specialist - Physician Based<br>
(CCS-P) - AHIMA<br>
required or at time of hire<br>
Certified Professional Coder (CPC) required or at time of hire<br>
Certified Professional Medical Auditor (CPMA) required at time of hire</div><div><b>
 UFJPI is an Equal Opportunity Employer and Drug Free Workplace</b></div></div>

Billing Compliance Analyst Team Lead | Phys Billing Compliance - Hybrid | Days | Full Time

Neighborhood Health Clinics Inc

<div><p><b>BILLING TEAM LEAD</b></p><p>
At Neighborhood Health, we&rsquo;re passionate about our mission to provide a kind and caring premiere workforce. Our team-based approach to comprehensive patient care creates a challenging and rewarding work environment where you have a direct role in helping members of our community receive quality medical services they can afford. And that&rsquo;s something you can feel good about.</p><p>
As a member of our growing team, you will feel at home in a fun and diverse community of healthcare professionals. Our goal is simple: improving access to healthcare in our community and surrounding areas. Together, we are all committed to building healthier communities by delivering comprehensive, quality health care with compassion and respect.</p><p>
As Billing Team Lead, you will oversee the activities of billing clerks. Maximize the collection of monies owed to NHC by Medical, Dental and Optometry self-pay patients and third party payers. Perform duties of direct reports at least 50% of the time. Maintain patient confidentiality and ensures compliance with HIPAA policies and procedures.</p><p><b>
SUPERVISORY RESPONSIBILITIES:</b></p><ul><li>
Assists the Revenue Cycle Manager in the day-to-day management of the billing department:</li></ul><ul><li>Coordinates work assignments and schedules of the Billing Clerks to ensure optimum patient flow.</li><li>Actively participates in patient complaint procedures to resolve operational problems.</li><li>Ensures compliance with NHC policies and procedures, Federal/State regulations (ex. OSHA/HIPAA), and other grant requirements.</li><li>Create user IDs as necessary for new employees.</li><li>Resolve billing issues and open eCW billing work tickets as necessary.</li><li>
Assists in ensuring department is staffed with qualified, competent employees:</li></ul><ul><li>Assists in interviewing prospective employees and provides input into the recommendations for hire.</li><li>Coordinates training and orientation for all new billing hires to provide training and orientation for the billing clerk role.</li><li>Provides input to supervisor for staff performance evaluations and disciplinary actions.</li><li>
Ensures department is functioning well as a team:</li></ul><ul><li>Communicates departmental goals and sets &ldquo;expectations of performance&rdquo; for each team member.</li><li>Identifies, analyzes, and facilitates resolution of any issues which are a barrier to the team achieving its goals.</li><li>Plays a vital role in the success of NHC employee communication by keeping both staff and administration informed of any changes, ideas, concerns, etc.</li><li>Analyzes the resources (staffing, equipment, technology, etc.) available to the department and when appropriate, recommends changes to improve efficiencies.</li></ul><ul><li>
Prepares staff timecards for payroll processing. Monitors staff attendance, tardiness, and overtime trends.</li><li>
Coaches Billing Clerks regarding issues/observations that arise, as needed.</li><li>
Performs duties in accordance with the Managers Standards of Conduct and NHC Mission Statement.</li></ul><p><b>
ESSENTIAL DUTIES &amp; RESPONSIBILITIES</b></p><ul><li>
Assists the Revenue Cycle Manager with the development and supervision of the billing department.</li></ul><ul><li>Coordinates with the Revenue Cycle Manager and management team on the goals/objectives of the billing department.</li><li>Provides information and reports to the Revenue Cycle Manager to clearly describe activities and progress toward agreed upon goals.</li><li>Responsible for ensuring data collection, preparing reports, answering correspondence, and compiling statistics for administrative and regulatory purposes, as required.</li><li>
Oversees the Billing operations:</li><li>Works with PSR departments to resolve denial issues and effectively train PSR staff to limit insurance denials.</li></ul><ul><li>
Process claims daily.</li><li>
Responsible for ERA processing.</li><li>
Responsible for claim resubmission (AR report).</li><li>
Take calls from Neighborhood Health employees about billing-related issues.</li><li>
Conducts periodic audits to ensure that staff is performing duties in accordance with NHC policies/procedures.</li><li>
Actively participates in resolving operational and patient flow problems (ex. Patient complaints, issues involving ancillary services, etc.).</li><li>
Works closely with various in-house departments such as Enrollment, Scheduling, Nursing, and PSR to resolve outstanding issues or assist patients.</li><li>
Performs duties of a billing clerk:</li></ul><ul><li>Assist with analyzing patient accounts to ensure accuracy, timely payment, timely referral to the collection process as necessary, and resolution of credit balances.</li><li>Handle phone inquiries from patients regarding statements and billing.</li><li>Run billing report.</li><li>Posts self-pa checks received in the mail daily.</li><li>Calculates patient&rsquo;s discounts by calculating household income.</li><li>Conducts insurance verification.</li></ul><ul><li>
Prepares periodic reports of work accomplished and compiles specific statistical data.</li><li>
Attends and participates in meetings and in-services as required. Participates in professional development activities. Chairs and serves on committees as requested.</li><li>
Performs duties in accordance with NHC Standards of Conduct and Mission Statement.</li><li>
Performs related work as required and other duties (similar physical requirements and OSHA risk level) as assigned.</li></ul><p><b>
REQUIRED SKILLS / ABILITIES:</b></p><ul><li>
Medical Office-demonstrates a working knowledge of medical and/or dental office procedures, third party insurance and medical/dental coding; maintains knowledge of, and acts in accordance with, current NHC policies and procedures.</li><li>
Problem solving&mdash;identifies and resolves problems in a timely manner and gathers and analyzes information skillfully; reacts calmly and effectively in emergency situations.</li><li>
Interpersonal skills&mdash;exhibits strong conflict management, negotiation and consulting skills; remains open to others&rsquo; ideas and exhibits willingness to try new things; maintains friendly and supportive relationships with coworkers; talks through problems to keep channels of communication open and maintain a high level of trust; realizes the importance of, and practices, good customer service; and able to communicate effectively with people of varying cultures, socio-economic backgrounds, languages, and educational levels.</li><li>
Oral communication&mdash;speaks clearly and persuasively in positive or negative situations, demonstrates group presentation skills.</li><li>
Written communication&mdash;edits work for spelling and grammar, presents numerical data effectively and is able to read and interpret written information.</li><li>
Planning/organizing&mdash;is self-directed and motivated; independently prioritizes, performs and completes assignments within established deadlines; manages multiple conflicting priorities; when appropriate, seeks guidance from supervisor.</li><li>
Quality control&mdash;understands the importance of compliance standards and pays close attention to accuracy and detail when performing duties; demonstrates a working knowledge of how grant requirements and federal/state laws impact the day-to-day operations of NHC&rsquo;s Medical Department.</li><li>
Adaptability&mdash;adapts to changes in the work environment, manages competing demands and is able to deal with frequent change, delays or unexpected events.</li><li>
Dependability&mdash;consistently at work and on time, follows instructions, responds to management direction and solicits feedback to improve performance.</li><li>
Safety and security&mdash;actively promotes and personally observes safety and security procedures, and uses equipment and materials properly.</li><li>
Computer &amp; Math&mdash;proficient in Microsoft Word, Outlook, and Excel; proficient in basic math to make simple calculations; proficient in the use of practice management software to efficiently and accurately perform duties.</li></ul><p><b>
REQUIRED QUALIFICATIONS:</b></p><p>
Education / Training - High School diploma or GED. Specialized training in medical and/or dental coding/billing preferred. Associates degree in a related field.</p><p>
Experience: Minimum of three years of work experience in a medical, public health, or social service agency. Minimum of one year of supervisory responsibility. Prefer experience with medical practice management systems. Additional appropriate education may be substituted for one year of work experience.</p><p><b>
Licensure/Certification:</b> None</p><p><b>
 Physical Requirements:</b></p><p>
Prolonged sitting, infrequent to occasional walking or standing. Requires ability to lift and carry items weighing up to 10 pounds. Requires eye-hand coordination and manual dexterity sufficient to operate office and related electronic equipment. Requires corrected vision and hearing to normal range to record, prepare, and communicate appropriate reports. Requires the ability to work under stressful conditions.</p><p><b>
 Work Environment:</b></p><p>
Normal medical office environment. Work may involve irregular hours, including evenings or weekends. Involves frequent contact with other staff, physician&rsquo;s offices, clients/patients, and the public. Contact may involve dealing with angry or upset people. Interaction with others is constant and interruptive. OSHA Category III - Tasks do not involve contact with blood or body substances and the performance of Category I or II tasks are not a condition of employment.</p><p>
Neighborhood Health is an Equal Opportunity Employer. Neighborhood Health does not exclude people or treat them differently for any aspect of the organization because of race, color, national origin, age, disability (physical or mental), or sex (including sexual orientation).</p><p>
If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. You can request reasonable accommodations by contacting Human Resources.</p></div>

Billing Team Lead

Amedisys

<div>Overview:
<p>
Responsible for performance of various clerical and billing duties including but not limited to accurate data input, maintenance of patient medical records, answering multi-line office phones.</p>
Responsibilities:
<ul><li>Inputs patient visit data from paper visit verification into the billing system to ensure accurate and timely billing and payroll processes.</li><li>
Input/generation of client data into HomeCare HomeBase with attention to detail and high level of accuracy for admissions and recertifications.</li><li>
Maintains tracking system for physicians' orders to maintain compliance in the billing processes.</li><li>
Notifies Director of Operations or designee as needed when documentation is delinquent from staff.</li><li>
Copies and distributes completed admission and patient information and all signed orders to appropriate staff.</li><li>
Responsible for pulling medical records and printing claims for billing review each billing cycle.</li><li>
Assists with checking of billing frequencies and orders every billing period.</li><li>
Assembles and organizes forms for admission packets, discharge packets, and post-hospital admission packets.</li><li>
Assembles new admission charts to import to EMR.</li><li>
Maintains security of patient records in locked files.</li><li>
Maintains filing of medical records, physicians' orders, lab reports, progress notes, and clinical notes on active and discharged patients in EMR.</li><li>
Conducts clerical audit on discharged charts and processes according to company policy.</li><li>
Tracks and maintains log of Medicaid and funding source records and orders.</li><li>
Performs verification and ongoing monitoring of Medicaid authorizations, approvals, and visits as directed.</li><li>
Assists the Clinical Manager or designee with payor follow-ups, as needed.</li><li>
Maintains office and medical supply inventory.</li><li>
Maintains ongoing scheduling of patient visits.</li><li>
Performs general office duties including, but not limited to, answering the telephones, greeting visitors, and handling the incoming/outgoing mail.</li><li>
Performs other duties as assigned.</li></ul>
Qualifications:
<div>Required-</div><ul><li>
High school diploma or equivalent.</li><li>
Two (2+) years' general office experience, with one (1+) of those years having experience data entry or word processing functions.</li><li>
Working knowledge of office practices and procedures.</li><li>
Strong computer/data entry and software skills.</li></ul><div>
Preferred-</div><ul><li>
Knowledge of medical terminology.</li></ul><p><i>
Amedisys is an equal opportunity employer. All qualified employees and applicants will receive consideration for employment without regard to race, color, religion, sex, age, pregnancy, marital status, national origin, citizenship status, disability, military status, sexual orientation, genetic predisposition or carrier status or any other legally protected characteristic.</i></p></div>

Business Office Specialist Hospice

Mosaic Life Care

<div><p>Works under the direction of the Home Services Billing Office Manager and within the established organizational and departmental policies and procedures, is responsible for accurate claim submission with payee guidelines, accounts receivable timely follow-up and denial management issues for patient accounts activity.</p></div>
<br><div><ul><li>Performs tasks required to ensure the timely and accurate submission of insurance claims to all third party payers and documents billing activity in the patient accounting system, such as: Reviewing electronic orders for additional information not sent in the interface transmission (i.e. handwritten information, attachments, copies of insurance cards) and updating system accordingly; completing and enter demographic information; interpreting and coding demographic information; performing specialized processing for accounts missing information; researching multiple systems for missing information and examining historical data to obtain missing information and retrieve per compliance guidelines; and contacting patient for missing information and updating system with new information accordingly.
</li><li>Accurately enters patient billing data, including supply changes into the information system.
</li><li>Works daily electronic billing file and submits insurance claims to third party payers. Reviews daily edit reports from the hospital and/or clinic billing system and makes necessary corrections to allow electronic submission.
</li><li>Reviews error reports from electronic payers; identifies errors and makes appropriate corrections to ensure accurate claim submission.
</li><li>Monitors claim rejections for trends and issues and reports findings to Billing Manager.
</li><li>Prepares and submits manual insurance claims to third-party payers who do not accept electronic claims or who require special handling.
</li><li>Coordinates medical record requests as needed.
</li><li>Documents billing activity on the patient account. Ensures Home Centric compliance with all state and federal billing regulations and reports suspected compliance issues to the Billing Manager.
</li><li>Works with supervision, management and the patient accounting staff to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department.
</li><li>Attends required training.
</li><li>Monitors for Medicare, Additional Development Requests (ADR) and alerts appropriate management of ADR.
</li><li>Other duties as assigned
</li></ul><br>
<b>Education
</b><ul><li>H.S. Diploma - High school diploma or GED equivalent - Required
</li></ul><br>
<b>Work Experience
</b><ul><li>Typing speed of 45 WPM preferred and 10-key by touch. - Required
</li><li>1 Year - Experience in accounting, collections and/or insurance billing - Preferred
</li><li>Computer experience - Preferred
</li></ul><br>
<b>Licenses and Certifications
</b><ul><li>Upon Hire
</li></ul><br>
<b>Travel Requirements
</b><ul><li>Travel to off-site locations may be required. - Required</li></ul></div>
<br><div><div>Mosaic Life Care is a health care system in northwest Missouri. With a vision of transforming community health by being a life-care innovator, Mosaic places the holistic needs of patients first by providing the right care at the right time and place, offering high value and quality health care.<br>
</div><div></div><br>
<div>Mosaic has a wide array of benefits to meet each employee&rsquo;s individual needs. Our benefits were designed by listening to people just like you. Mosaic also offers several perks with a focus on ensuring our employees feel valued, including concierge services, employee lounge, wellness programs, free covered parking, free on-site and virtual health clinics and many more. When paired with compensation and recognition, it is what continues to make us the employer of choice for employees at any stage of their journey.</div></div>

Home Services Billing Representative

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