RCM Billing Specialist

Position Overview:

The Billing Specialist performs a variety of account receivable functions to ensure the maximization of cash flow, while improving customer service, client relations, and achievement of key metrics.  They are responsible for following up on submitted claims, and the overall billing process. The Ideal candidate for this role will have experience in both FQHC, and Community Health Centers. 

Key Responsibilities:

Operations: 

• End-to-end billing process, including accurate invoicing, documentation, and timely payment collection.

• Identify and implement improvements in billing workflows to reduce processing time, eliminate errors, and enhance efficiency. Recommend system or process upgrades to improve speed and accuracy.            

• Serve as a point of contact for complex billing inquiries, issues, and disputes that require advanced problem-solving or technical expertise.           

Reporting & Analytics:

• Prepare, analyze and present accounts receivable reports, and daily, weekly, and monthly financial reports. 

• Monitor KPIs, SLAs, month-to-date targets, and productivity. Present findings to management on a daily, weekly, monthly, and quarterly basis.  

Continuous Improvement:

• Analyze trends in AR issues, think strategically to enhance revenue cycle operations, and make confident decisions under pressure to drive continuous improvement. 

• Assist in initiatives aimed at improving billing accuracy, timeliness, and efficiency through process enhancements and automation.

Requirements:

• Educational Background: Bachelor’s degree in Business, Finance, Healthcare Administration, or related field (preferred).

• Experience: 3-5+ years of experience in accounts receivable, revenue cycle management. 

  • Familiarity with credentialing, and other health center operations. 

• Expert Industry Knowledge: Proficiency in revenue cycle management platforms, workflow automation tools, and data analytics for AR tracking. Knowledge of HIPAA, Medicare, Medicaid, and payer regulations.

• Collaboration & Communication: Ability to work independently and collaborate with cross-functional teams.

• Detail-Oriented: High level of accuracy, with the ability to set and maintain priorities in a fast-paced environment

Preferred:

• FQHC, or experience with Community Health Centers 

• Experience working in ECW