FQHC Revenue Cycle Specialist: Medicare Billing Pro

Friend Health; Chicago (IL); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

403(b) Retirement Plan

Paid Time Off & Holidays

Life Insurance & Disability Coverage

Tuition Reimbursement & Professional D

Job summary

Friend Health – HRDI seeks a Revenue Cycle Specialist – FQHC Billing to ensure timely, accurate, and compliant FQHC billing, follow-up, and account resolution. You will verify eligibility, monitor Medicare/Medicare Advantage claims, and collaborate across clinical, billing, credentialing, and payer teams to support reimbursement and financial stability.

The role requires strong knowledge of FQHC guidelines, PPS, and payoff processes, with 3–5 years of revenue cycle experience in healthcare.

Qualifications

• Three to five years of experience in revenue cycle, medical billing, claims follow-up, or patient accounts in healthcare; FQHC experience preferred.
• Knowledge of FQHC billing guidelines and Medicare PPS is required.
• Working knowledge of Medicare FQHC billing and Medicare Advantage supplemental/wrap payment guidelines.
• Ability to review remittance advice and identify incorrect payments or denials.
• Knowledge of payer-specific billing rules, eligibility, coordination of benefits, and authorization processes.
• Familiarity with ICD-10-CM, CPT, and HCPCS coding principles; escalate code issues when needed.
• Proficiency with EHR, practice management/billing systems, clearinghouses, payer portals, and Microsoft Office.

Responsibilities

• Review and process FQHC claims for accurate charge capture, coding, submission, and reimbursement.
• Apply FQHC billing guidelines and Medicare PPS methods.
• Verify payer, financial class, provider, place of service, CPT/HCPCS, modifiers, codes, and data elements for compliant billing.
• Monitor Medicare and Medicare Advantage claims for payment and denials; research discrepancies.
• Reconcile reimbursement to remittance activity (ERAs/835s, EFTs, adjustments).
• Follow up on unpaid or denied claims within filing and appeal deadlines.
• Identify recurring denial root causes and communicate findings to Revenue Cycle leadership.
• Collaborate with clinical, coding, credentialing, and payer representatives to resolve issues.
• Maintain documentation of claim corrections, appeals, and payer contacts.

Skills

Revenue cycle experience

Billing accuracy

Analytical skills

Attention to detail

Communication skills

Multitasking

Team collaboration

Adaptability

Education

High school diploma or equivalent

Associate degree in Healthcare Administration / Business / Accounting / Finance

Tools

EHR systems

Practice management / billing systems

Clearinghouses

Payer portals

Microsoft Office Suite

Job description

Friend Health – HRDI seeks a Revenue Cycle Specialist – FQHC Billing to ensure timely, accurate, and compliant FQHC billing, follow-up, and account resolution. You will verify eligibility, monitor Medicare/Medicare Advantage claims, and collaborate across clinical, billing, credentialing, and payer teams to support reimbursement and financial stability.

The role requires strong knowledge of FQHC guidelines, PPS, and payoff processes, with 3–5 years of revenue cycle experience in healthcare.