FQHC Medical Billing Specialist Hudson Valley Regional Community Health Centers Brewster, NY Job Details Full-time $50,000 - $60,000 a year 1 day ago Benefits Health insurance Dental insurance 401(k) Paid time off Parental leave Vision insurance Loan forgiveness Life insurance Retirement plan Qualifications Appeals Written communication Self-direction Medicare Electronic health records (EHR) management Finance Patient management software Electronic health record (EHR) management for billing and coding Attention to detail Centers for Medicare & Medicaid Services (CMS) billing regulations Medicaid regulations Medicaid Medical Billing Certification Communication skills Full Job Description Hudson Valley Regional Community Health Centers (HVRCHC), is a Federally Qualified Health Center that provides comprehensive health care services to ensure the individual health, well-being and quality of life of each person served. Services include primary care medical services, mental health services, dental services, rehabilitation and specialty services with sites in Brewster, NY, Poughkeepsie, NY and other locations in the region. We are seeking an experienced and detail-orientated FQHC Medical Billing Specialist to join our team. In this role you will manage the unique submission, tracking and reconciliation processes required for Federally Qualified Health Center (FQHC) reimbursement. The Billing Specialist will report to the Director of Finance and work closely with the third party billing service.

Main responsibilities include:

Claims Processing:

Send clean electronic or paper claims to Medicare, Medicaid and commercial plans using the correct CPT, HCPCS, ICD-10 and revenue codes.

Specialized Billing:

Apply FQHC specific rates and wrap around insurance logic alongside sliding fee scale adjustments.

Denial Management:

Research claims rejections, unpaid claims, correct errors and refile unpaid accounts. Write appeals and follow up as necessary.

Payment Posting:

Record insurance and patient payment, contractual adjustments and credits accruals.

Compliance and Coordination:

Follow HRSA rules and work with Front-desk, HR and clinical teams to fix encountered data issues.

Requirements:

Experience:

Previous experience in medical billing or revenue cycle management ideally within an FQHC or community health setting.

Knowledge:

A deep knowledge of Prospective Payment System(PPS), FQHC billing requirements and Medicaid/Medicare billing and sliding fee scales.

Technical Skills:

Familiarity with Electronic Health Record (EHR) Systems and practice management systems like eClinicalworks. Understanding of HRSA compliance guidelines.

Credentials:

Certified Professional Biller (CPB) preferred.

Competencies:

Attention to detail and excellent verbal & written communication skills. Ability to work independently. Hudson Valley Regional Community Health Centers provides a comprehensive benefits package including competitive health care, dental, and vision benefits, retirement savings plan, paid time off, additional life insurance programs, and the ability to apply for student loan forgiveness programs (restrictions apply). Hudson Valley Regional Community Health Centers, Inc. provides high quality, primary medical, specialty medical, rehabilitation, dental and ancillary health services to patients, to include those who are underserved with a special focus on the needs of people with disabilities and chronic health conditions. Hudson Valley Regional Community Health Centers, Inc. will maintain a culturally sensitive service environment and will not discriminate on the basis of ability to pay.

Pay:

$50,000.00 - $60,000.00 per year

Benefits:

401(k) Dental insurance Health insurance Life insurance Paid time off Parental leave Retirement plan

Experience:

Medical Billing :

3 years (Required) PSS/APM reimbursement model: 1 year (Preferred)

Community Health/ FQHC:

3 years (Preferred)

License/Certification:

Medical Billing Certification (Preferred)

Work Location:

In person