RCM Billing and Reimbursement Manager II, Grant Service Specialist III (NCS) - Baltimore City Health Department

Baltimore City•Baltimore, MD

63d•$64,427 - $110,756

About The Position

Under the supervision of the Director, Revenue Cycle Management. RCM Billing and Reimbursement Manager II is responsible for assigned programs within the Bureau of Maternal Child Health (MCH); in both a hands-on and leadership role for Baltimore City Health Department (BCHD). In the role of RCM Billing and Reimbursement Manager II, daily work activities include medical billing charge capture, patient enrollment demographics, patient eligibility and claims submission. Identifying workflow bottlenecks and solutions. Resolving claims rejections/denials, ensuring clean data and claims are entered into state systems and practice management portals. Be a subject matter expert in billing / reimbursement guidelines for the Bureau of MCH and Maryland Medicaid. RCM Billing and Reimbursement Manager II will reconcile all charges, patient enrollment data/ demographics, reimbursements, claims denials to prepare month end reports and maintain RCM dashboard. RCM Billing and Reimbursement Manager II will provide excellent customer service to our community partners, parents, and internal cross-functional teams.

Requirements

Must have verifiable 6 or more years hands on experience in: Working knowledge with medical claims clearinghouse
Charge capture
Processing & Submitting Claims, and Resolving Claim Denials
Patient Communication - Verifying Patient Insurance - Data Entry
Generating monthly reports / maintaining billing dashboard / Ad-hoc reports
Revenue Cycle Management integrity
Resolve A/R discrepancies - Claim denials management
Timely filing guidelines - Medicaid, Medicare, third party billing guidelines
Interpreting EOBs, payer remits from various insurance payers
Working knowledge of CPT and ICD-10 code application
Have a bachelor’s degree from an accredited college or university.
Have six (6) years of experience in medical billing and reimbursement in a physician office or group setting.
Must have previous experience with physician billing system and previous experience with MS Office products (Word, Excel, Outlook).
EPIC EMR/PM - REQUIRED
Must be able to read, write, and speak the English language in an understandable manner.
Must be able to work independently and possess the ability to make independent decisions when circumstances warrant such action.
Must possess the ability to effectively communicate and deal tactfully with other personnel, visitors, patients, physicians, customers, and the general public.
Must be flexible, have personal integrity, and the ability to function effectively as a team with other employees.
Must be able to follow written and oral instructions.

Responsibilities

Medical billing charge capture
Patient enrollment demographics
Patient eligibility and claims submission
Identifying workflow bottlenecks and solutions
Resolving claims rejections/denials
Ensuring clean data and claims are entered into state systems and practice management portals
Subject matter expert in billing / reimbursement guidelines for the Bureau of MCH and Maryland Medicaid
Reconcile all charges, patient enrollment data/ demographics, reimbursements, claims denials to prepare month end reports and maintain RCM dashboard
Provide excellent customer service to our community partners, parents, and internal cross-functional teams