Billing Supervisor ($5,000 Sign-on Bonus)

Essential Functions: These functions are fundamental to the role and must be performed with or without a reasonable accommodation.

1. Oversees all billing functions.
   
   
   
   1. Reviews, implements, and updates all billing policies and procedures with attention to compliance with federal and state regulations.
   
   
   2. Directs all billing of patients, third party payers, and county agencies, with appropriate follow-up of all rejected claims.
   
   
   3. Establish and maintain rapport with third party payers and agencies to facilitate ongoing "clean claims" submission. Maintains accurate record maintenance and retention to facilitate regulatory compliance and optimize reimbursement. Ensures timely and accurate paper flow through the system consistent with regulatory guidelines. Maintains current extensive knowledge of CPT, ICD, CDT coding.
   
   
   4. Directs all crediting and collections activity within CVCH system.
   
   
   5. Ensures workflows align with FQHC PPS, wrap, and cost-based reimbursement rules.
   
   
   6. Maintains knowledge of UDS reporting impacts related to billing and coding.
   
   
   
   


2. Maintains regulatory compliance.
   
   
   
   1. Ensures that policies are accurate and up-to-date. Reviews all billing inquiries and reports of non-compliance and provides investigation and resolution. Maintains current extensive knowledge of State and Federal regulations applicable to billing processes.
   
   
   2. Conducts internal audits to monitor ongoing compliance with State and Federal regulations.
   
   
   3. Provides interpretation and implementation of billing policies and procedures to Billing Department staff and providers.
   
   
   4. Ensures billing processes comply with HRSA Program Requirements, OIG Guidelines, and FQHC-specific billing regulations.
   
   
   5. Monitors processes associated with Sliding Fee Discount Program, including correct application of discounts.
   
   
   
   


3. Auditing and reporting Responsibilities.
   
   
   
   1. Establishes and maintains internal audit controls including charge review and denial trend analysis. Develops and presents monthly dashboards to Revenue Cycle Director including AR aging, denial categories, charge lag, and clean-claim rate.  Serves as subject matter expert during internal and external audits.
   
   
   2. Educates providers regarding any documented billing infractions of State or Federal regulations.
   
   
   
   


4. Training and Staffing Responsibilities.
   
   
   
   1. Provides instruction and training regarding policies and procedures to Billing Department Staff. Monitors Billing Department staff performance through quarterly proficiency testing. Provides interpretation of State and Federal billing regulations for Billing department staff and other CVCH staff.
   
   
   2. Acts as organizational liaison to Information Technology personnel regarding billing issues.
   
   
   3. Demonstrates continuous effort to improve operations, decrease turnaround times, streamline work processes, and work cooperatively and jointly to provide quality seamless customer service.
   
   
   4. Conducts routine 1:1 meetings and annual performance evaluations.
   
   
   5. Develops cross-training plans to ensure departmental coverage.
   
   
   
   

1. Accounts Receivables.
   
   
   
   1. Supervises the compilation of financial and accounting statements and reports; coordinates the reconciliation of accounts receivable and verifies reports at month end. Coordinates and monitors the day-to-day workload in the department to ensure deadlines are met; reviews periodic reports for error ratings and denied billings. Ensures control and accuracy of data entry of the revenues received into the automated billing system.
   
   
   2. Analyzes department charges to ensure correct billing and monitors the department’s expenditures to stay within approved budgets.
   
   
   3. Supervises and reviews adjustments to patient’s accounts; documents and maintains historical corrections in the automated billing system.
   
   
   4. Supervises and coordinates activities involved in maintaining and processing various accounting and financial records associated with billing, revenue, collection and record keeping activities.
   
   
   5. Develops strategies to reduce avoidable denials and prevent rework.
   
   
   
   


2. NextGen & Athena Electronic Practice Management (EPM) Administrator.
   
   
   
   1. As the Billing Supervisor, provides direction to Medical, Dental, Behavioral Health and Billing staff on optimizing the use of the electronic patient management system through training and regular reporting and review. Performs system implementation, maintenance, training, and user support, as required. Implements and builds table design and system testing. Acts as key technical resource for other staff, providing advice, training support for various projects relating to Athena Collector. Assists with developing policies and procedures relating to EPM Plans.
   
   
   
   

Essential Duties & Responsibilities: These functions are fundamental to the role and must be performed with or without a reasonable accommodation.

1. Performs other duties and tasks as assigned by supervisor.


2. Start shift on time and meet attendance standards per the FTE assigned in HRIS system.


3. Follow safety policies and maintain a clean, safe work environment.


4. Demonstrate sound work ethics, flexibility, and cultural sensitivity.


5. Uphold CVCH’s mission and core values in all interactions.


6. Comply with CVCH policies, Joint Commission standards, and HIPAA regulations.

Non-Essential Functions: These are tasks that are included in the role but are not critical. They may be reassigned or modified without fundamentally changing the job.

• Participate in internal committees or special projects.


• Contribute to internal communications

Qualifications:

• Education: Associate’s degree required. Bachelor’s degree in accounting or related field preferred. Combination of education and work experience may be substituted for degree.

• Certification/Licensure: The following certifications are preferred: CPB, CHFP, CPC, CH-CBS, FQHC billing certificate programs.

• Experience: Must have 3 years of third-party billing experience, which includes and Medicare billing experience in a health care agency, and 1 year of supervisory experience.

• Experience with NextGen and Athena (administration, configuration, reporting, and workflow optimization) preferred

• Language Skills: English fluency required

Work Environment & Physical Demands:

• Typical office environment


• Sit, stand, walk, often


• Reach occasionally


• Kneel or crouch minimally


• May need to lift up to 20 pounds


• Visual acuity for close and distance work

Exposure to Hazards:

• Moderate noise


• Standard administrative working conditions

Blood/Fluid Exposure Risk:

• Category III – Tasks involve no greater exposure to blood or body fluids than would be encountered by a visitor.

Age-Specific Competency:

• Not applicable – position does not involve patient care.

Telecommuting:

Position eligible for partial telecommuting.

Equal Opportunity Statement:

• CVCH is an equal opportunity employer and embraces diversity in the workplace. We are committed to providing a respectful, inclusive, and supportive environment for all employees.

Benefits

*Coverage below based on a 1.0 FTE; Medical, Dental, Paid Leave, Holidays are prorated based on FTE