Optimus Health Care - Stratford, CT

posted 5 months ago

Full-time - Mid Level
Stratford, CT
Ambulatory Health Care Services

About the position

Optimus Health Care is a Federally Qualified Health Center (FQHC) that operates in Bridgeport, Stamford, and Stratford, CT. As the largest provider of primary health care services in Fairfield County, we are dedicated to serving all patients, regardless of their ability to pay. We are currently seeking a Billing Manager to join our collaborative team in Stratford, CT. The Billing Manager will oversee all aspects of the billing process for the health center, ensuring compliance with federal and state regulations while optimizing revenue cycle management. This role involves working closely with the Director of Revenue Cycle to establish effective claims management processes and controls, ensuring the accuracy and timeliness of claim submissions and collections efforts. The Billing Manager will also proactively identify, develop, and execute solutions to improve overall effectiveness and efficiency within the billing and collections area, ensuring that the billing staff meet or exceed key performance metrics. The essential functions of the Billing Manager include managing billing operations, revenue cycle management, staff management, compliance and quality assurance, technology and system management, collaboration and communication, and patient relations. The Billing Manager will assist with the daily oversight of the billing department, monitor billing processes for compliance, implement and maintain billing policies, and analyze key performance indicators related to billing and collections. Additionally, the manager will supervise and mentor billing staff, conduct performance evaluations, and ensure the team is updated on changes in billing regulations. Compliance with applicable laws, including HIPAA, is critical, and the Billing Manager will conduct regular audits of billing activities to identify and correct errors. The role also involves overseeing the implementation and maintenance of billing software and systems, ensuring data integrity and security, and collaborating with other departments to ensure smooth operations. The Billing Manager will address patient inquiries related to billing and implement processes to enhance patient satisfaction with billing services. This position requires a strong understanding of medical billing and coding practices, knowledge of FQHC billing requirements, and excellent leadership and team management skills. A Bachelor's degree in healthcare administration, business, or a related field is preferred, along with a minimum of 5 years of experience in medical billing, including 2-3 years in a supervisory or management role.

Responsibilities

  • Oversee all aspects of the billing process for the health center.
  • Manage the billing staff and ensure compliance with federal and state regulations.
  • Optimize revenue cycle management and establish effective claims management processes.
  • Assist with the daily oversight of the operations of the billing department.
  • Monitor billing processes to ensure compliance with regulations.
  • Implement and maintain billing policies and procedures to optimize efficiency.
  • Assist with the development and implementation of strategies to improve revenue cycle performance.
  • Analyze and report on key performance indicators (KPIs) related to billing and collections.
  • Identify and resolve issues related to claim denials, rejections, and underpayments.
  • Supervise and mentor billing staff, providing guidance and training as needed.
  • Conduct performance evaluations and address any performance issues.
  • Ensure the billing team is up to date with changes in billing regulations and practices.
  • Ensure all billing practices comply with applicable laws and regulations, including HIPAA.
  • Conduct regular audits of billing activities to identify and correct errors.
  • Work with the compliance officer to address any compliance issues.
  • Oversee the implementation and maintenance of billing software and systems.
  • Work with IT staff to troubleshoot and resolve system issues.
  • Ensure data integrity and security within billing systems.
  • Collaborate with other departments to ensure smooth operations.
  • Assist financial management with quarterly and annual financial reporting of billing and receivable data.
  • Communicate regularly with management regarding billing issues, challenges, and performance.
  • Participate in management meetings and contribute to strategic planning.
  • Address patient inquiries and concerns related to billing.
  • Ensure patient billing statements are accurate and understandable.
  • Implement processes to enhance patient satisfaction with billing services.

Requirements

  • Strong understanding of medical billing and coding practices.
  • Knowledge of FQHC billing requirements and regulations.
  • Excellent leadership and team management skills.
  • Proficiency in billing software and electronic health records (EHR) systems; EPIC preferred.
  • Strong analytical and problem-solving abilities.
  • Excellent communication and interpersonal skills.
  • Demonstrated ability to analyze complex problems and to arrive at sound decisions or recommendations.
  • Knowledge of financial reporting in a community healthcare environment and to effectively operate within budget constraints.
  • Must be able to work a flexible schedule when required.

Nice-to-haves

  • Bi-lingual English/Spanish is helpful but not required.
  • CCA, CPB, CMRS or CPC certification desirable.

Benefits

  • 100% Outpatient Setting
  • Excellent health & welfare benefit options
  • Competitive Compensation
  • Fun, fast-paced working environment
  • Commitment to quality in every job function.
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