Medical Billing Manager

While this role is primarily remote, the candidate must live within a reasonable commuting distance from Raleigh, NC.

Position Summary

Responsible for the billing team leadership, subject matter expertise, and organizing and performing a variety of regular tasks to ensure timely and comprehensive billing and collections for services rendered by NHC providers; supervises billing specialists and is expected to devote 50% of work time to team leadership and subject matter expert responsibilities.

Principal Duties and Responsibilities*

Team Leadership

1. Supervise and coordinate the workload of the billing staff to ensure all tasks are completed accurately and in a timely manner.

2. Define and communicate current and new billing tasks and definitions of the billing team.

3. Recommend and report billing issues of concern or accommodation to the clinic manager for action.

4. Run, work, and manage reports for the purpose of verifying quality and completeness of various data entry and other functions in EPIC.

5. Communicate with NHC staff about missing and erroneous data and ensure the completion and correction of the same.

6. Work collaboratively with other members of the organization to maximize accuracy, efficiency, and promptness of the claim life cycle.

7. Troubleshoot other problems in various billing processes and document to resolution problems discovered.

8. Maintain and control documentation of billing processes.

9. Execute quality control processes to ensure consistent billing and collection.

10. Monitor third party coverage contracts, ensuring that current contractual terms are understood and applied correctly.

11. Assist accounting with reconciling EPIC monthly deposit reports to the general ledger deposits.

12. Assist CFO in completion of the annual cost reports, financial audit, annual UDS report, and any other required annual governmental reporting.

13. Create and foster an environment that encouraged professional growth of billing specialists.

14. Other duties as assigned.

Billing Subject Matter Expert

1. Study and evaluate new and changing billing requirements and recommend solutions.

2. Work directly with managers to revise processes and resolve issues.

3. Document significant billing changes and methods for management awareness.

4. Monitor changing standards and methods in billing to ensure NHC methods and processes are current.

Organizing and Performing Other Tasks

1. Manage and coordinate the billing team’s work results for quality, accuracy, and timeliness.

2. Oversee and review the transmission of claims in EPIC as well as other electronic and paper claim processing.

3. Following up on unpaid claims within standard billing cycle timeframe.

4. Oversee payment processing for accuracy and compliance.

5. Provide customer service to patients enquiring about their accounts and process requests for refunds.

6. Provide ongoing orientation and training to staff.

Required Skills or Abilities*

1. Computer literacy in internet use and Windows environment, including Outlook, Word, and Excel with keyboarding skills of at least 45 wpm.

2. Advanced skills in math.

3. High level of attention to detail

4. Ability to handle a large volume of work in an efficient manner.

5. Effective communication abilities for contacts with insurance payers, patients, and NHC staff to resolve issues.

6. Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.

7. Ability to work in a team environment.

8. Able to triage priorities, delegate tasks if needed, and handle conflicts in a reasonable fashion.

9. Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.

10. Ability to cultivate and develop inclusive and equitable working relationships with co-workers and community members.

11. Ability to serve as an advocate for individuals of all ethnicities, genders, ages, and backgrounds.

Required Knowledge, Experience, or Licensure/Registration

1. Associate’s degree in medical billing and coding preferred or a combination of education and experience.

2. Minimum of five years’ progressive billing experience required, including supervisory duties.

3. FQHC experience.

4. Mastery of insurance basics and practices.

5. Mastery of medical billing terminology.

6. Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.

7. Familiarity with CPT and ICD-10 coding.

8. Working knowledge of NHC’s practice management system, EPIC.

9. Certified coding certificate or comparable experience required.

10. Ability to work without constant supervision and adhere to policies and procedures.

11. Ability to work remotely via a home office set up with access to secure Internet connection.

12. Ability to read, write, speak, and comprehend English fluently.

13. Vaccines as required.

Physical requirements of the Job*

1. Sitting or standing (often for prolonged periods)

2. Carrying or lifting objects up to 20 pounds

This is a full-time, exempt position.

*To comply with the Americans with Disabilities Act of 1990 (ADA), which prohibits discrimination against qualified individuals on the basis of disability, it is necessary to specify the physical, mental and environmental conditions of the essential duties of the job.

NeighborHealth Center is an Equal Opportunity Employer, including disability and veterans. NHC is dedicated to building a culturally diverse staff committed to serving a diverse patient population.