Billing Manager

WESTERN SIERRA MEDICAL CLINIC INC•Grass Valley, CA

5d•$37 - $42

About The Position

Western Sierra Medical Clinic is an engaging, enthusiastic, mission driven organization dedicated to providing high-quality primary care to all members of our community. This includes the delivery of evidence-based preventative care, chronic disease management, and addressing urgent care needs as indicated for our pediatric and adult patient population. GENERAL STATEMENT OF DUTIES The Healthcare Billing Manager plays a pivotal role in the financial operations of WSMC. This professional is responsible for overseeing the billing department, managing medical billing processes, ensuring accurate coding and claim submissions, and optimizing the revenue cycle. The position requires an intricate blend of leadership, technical expertise, compliance awareness, and excellent communication skills to effectively coordinate billing operations and support overall organizational success.

Requirements

Minimum 3+ years in a billing manager role
3+ years of FQHC billing oversight
High School Degree
Must have valid DL with clean DMV readout.
Proficiency in the use of a computer, knowledge of Microsoft Office, Excel, and ability to master in-house computer systems.

Nice To Haves

BA in business
Certified Professional Coder
California specific experience

Responsibilities

Supervision of billing staff – lead, train, and supervise a team of billing specialists, coders, and accounts receivable personnel. Assign tasks, monitor performance, provide feedback, and foster a collective, high-performing work environment.
Oversee daily billing activities, such as claim generation, submission, follow-up, and payment posting. Ensure accuracy, completeness, and timeliness in every stage of the billing cycle.
Analyze workflows and implement best practices to maximize collections and minimize denials. Monitor key performance indicators (KPIs) related to billing efficiency and revenue realization.
In collaboration with the front office supervisor, train and monitor the patient registration function to ensure front office staff are entering all required patient financial information accurately and timely.
Oversee provider and facility credentialing with third party payers and maintenance of organized files and a credentialing progress grid. Report current credentialing to management.
Provide oversight of all billing compliance (Family PACT, Enhanced Care Managements, etc.)
In collaboration with the Controller and CFO, review and initiate third-party payer contracts.
Research, launch and implementation of new billing opportunities.
Foster a positive, customer service-oriented work environment.
Review internal policies and procedures and recommend updates and changes as needed.
Participate as assigned in interdepartmental quality improvement team efforts; and contributes to overall Community Health Center efforts in quality improvement towards higher-quality, more cost-effective health care for patients.
Ensures sliding fee scale applications and renewals procedures are compliant with HRSA grant requirements and company policies.
Provide oversight of the fee schedule.
Complete various special projects, which require reviewing and analyzing information, identifying problems, recommending solutions, and providing status reports.
Perform management functions, including review and approve employee timesheets and submit on a timely basis. Enforce prior approval of employee overtime. Conduct performance evaluations, progressive discipline and approve vacations and time off ensuring adequate coverage in the department. Maintain a positive tone and provide structure and guidance to the staff supervised to ensure training, development and concerns are adequately addressed.