Description
In this role, you will be instrumental in ensuring that billing processes are accurate, timely, and compliant with healthcare regulations. Collaboration with the Billing Lead, Revenue Cycle Director, and other team members will be essential to maintain high standards of billing accuracy and efficiency. We seek a detail-oriented, proactive individual who is passionate about contributing to the financial health and stability of our organization.
Essential Duties And Responsibilities
- Processing Daily Billing Encounters (35%)
Accurately process daily encounters for services provided by Care Managers, ensuring compliance with billing standards.
Core Value: Building Solutions - Efficiently process encounters to support the financial stability of the organization.
- Charge Entries Proofing and Posting (20%)
Proof and post charge entries daily, focusing on accuracy and attention to detail.
Core Value: Having Fire - Approach each task with enthusiasm and a commitment to excellence.
- Eligibility and Benefits Verification (15%)
Regularly verify eligibility and benefits for chronic care management services, ensuring compliance with payer requirements.
Core Value: Being Driven - Proactively verify patient information to prevent delays or errors in billing.
- Communication with Billing Lead and Revenue Cycle Director (10%)
Maintain open lines of communication with key stakeholders to promptly resolve any billing issues.
Core Value: Being Partners - Foster collaboration and effective communication to ensure smooth operations.
- Billing Clean Claims Daily (15%)
Ensure that clean claims are billed daily to payers, maintaining department standards and improving cash flow.
Core Value: Building Solutions - Submit claims correctly on the first attempt to reduce rework and improve efficiency.
Actively participate in daily team huddles and other relevant meetings to stay aligned with team goals and updates.
Core Value: Being Coaches - Engage with the team, share knowledge, and contribute to collective success.
Key Performance Indicators (KPIs)
- Billing Accuracy: Aim for 98% accuracy in daily billing encounters, monitored through monthly audit reports.
- Timeliness: Proof and post 100% of charge entries daily, tracked through performance logs.
- Eligibility Verification: Complete verification within 24 hours of service, as reflected in weekly performance reports.
- Issue Resolution: Resolve 95% of billing issues within 48 hours, tracked through resolution logs.
- Clean Claims Submission: Achieve a 99% clean submission rate on the first attempt, measured through monthly reports.
- Team Engagement: Participate in 90% of daily huddles and meetings, recorded through attendance logs.
Minimum Education And Experience Requirements
- Proficiency in FQHC/CHC/RHC billing.
- Experience with EHR systems such as eCW, EPIC, Athena, or NextGen.
- Knowledge of healthcare reimbursement programs, including Medicare, Medi-Cal, Managed Care Health Plans, or private insurance.
- Ability to work independently while also being a collaborative team player.
- Strong presentation skills with a keen attention to detail.
Desired Skills And Experience
- Strong critical thinking and problem-solving skills.
- Results-oriented with a high level of integrity and dependability.
- Excellent interpersonal and communication abilities.
- Effective time management and organizational skills.
- Basic computer proficiency, particularly in Microsoft Office.
- Self-motivated, proactive, and adaptable to changing circumstances.
- Ability to work remotely in a quiet, distraction-free environment with a reliable internet connection.
Core Values
- Having Fire: Bringing passion and energy to your work.
- Being Driven: Proactively striving for excellence in all tasks.
- Being Partners: Collaborating effectively with colleagues and stakeholders.
- Building Solutions: Finding efficient and effective ways to solve problems.
- Being Coaches: Supporting and uplifting the team through shared knowledge and encouragement.
Employment Type: Full-Time