Manager FQHC Billing & Revenue Integrity-AR Management (Prof)

MetroHealth; Cleveland (OH); On-site; USD 70,000 - 100,000; Full time

Job summary

MetroHealth System in Ohio seeks a revenue cycle professional to optimize charge capture and maximize patient revenue across FQHC locations. You will implement charge capture processes and educate clinical teams on policy alignment with payers and government regulations.

Qualified candidates bring EPIC experience, data analysis skills, and a strong command of MS Excel; healthcare revenue cycle knowledge is essential. This on-site role emphasizes collaboration with clinical staff and stakeholders.

Qualifications

• Bachelor's degree in Accounting, Finance or Healthcare Management.
• 4 years' experience with EPIC and major billing systems.
• Healthcare revenue cycle knowledge.
• Proficient in MS Excel, Access, PowerPoint.

Responsibilities

• Maintain revenue capture across FQHC locations and maximize collections.
• Implement and maintain charge capture processes.
• Collaborate with clinical departments to align policies with payer rules.
• Coordinate activities related to collections, accounts receivable, and denial management.

Skills

EPIC Experience

Billing data analysis

Data analysis

MS Excel

Communication skills

Time management

Independent work

Education

Bachelor's Degree in Accounting/Finance/Healthcare Management

CPC Certification (in lieu of degree)

Tools

EPIC Billing System

Job description

Location: MetroHealth Old Brooklyn Campus

Biweekly Hours: 80.00

Shift: 8 am- 5pm

The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it. Founded in 1837, Cuyahoga County's safety-net health system operates four hospitals, four emergency departments and more than 20 health centers.

Summary:

Maintains the integrity of the revenue capture system across the Federally Qualified Health Centers (FQHC) Locations. Focuses on the maximization of collections through the accurate and complete capture of all charges as well as the implementation and maintenance of charge capture processes. Works closely with clinical departments to align processes with government, payer, and internal charge capture policies; provides education to the clinical departments. Utilizes knowledge of governmental and third-party payer regulations, billing, and reimbursement processes. Assists in coordinating and overseeing all activities related to collections and accounts receivable management. Ensures all activities related to collection functions include, but are not limited to; claim status, denial management, aged account follow up and resolution for Patient Financial Services are coordinated with other revenue management functions to meet customer requirements, maximize revenue collection and achieve best practice targets. Upholds the mission, vision, values, and customer service standards of The MetroHealth System.

Qualifications:

• Required: Bachelor's Degree, preferably in Accounting, Finance or Healthcare Management.
• In lieu of a Bachelor Degree, will accept Certified Professional Coder (CPC).
• 4 years of demonstrated experience with EPIC and/or major industry standard billing system.
• Financial analytical experience in a healthcare environment.
• Demonstrated experience with FQHC Revenue Cycle Operations.
• Demonstrated knowledge of healthcare revenue cycle practices.
• Demonstrated ability to manipulate and analyze data derived from disparate source systems.
• Advanced knowledge of MS Excel, Access, PowerPoint and query tools to create reports and financial models.
• Excellent time management and project prioritization skills with ability to multi-task.
• Detail oriented with demonstrated ability to work independently.
• Good written and verbal communication and interpersonal skills.
• Ability to facilitate group meetings and interview sessions.
• Must be knowledgeable in all third-party billing requirements and Coordination of Benefits (COB).
• Analytical aptitude and ability to translate functional needs to an integrated technical/professional computerized environment.

Preferred:

• Progressive management experience.
• MBA/MPH/MHA/MHS or other certification such as CPA.
• Certification in billing and coding represented by any of the following: RHIA, RHIT, RN, CPC, COC, CCS, or CCS-P
• High level of quantitative and qualitative research, analytical skills and critical thinking skills with expertise to drive process development to implementation.

Physical Demands: May need to move around intermittently during the day, including sitting, standing, stooping, bending, and ambulating. May need to remain still for extended periods, including sitting and standing. Ability to communicate in face-to-face, phone, email, and other communications. Ability to read job related documents. Ability to use computer.