Billing Coordinator/Billing & Revenue Operations Lead

Billing Coordinator/Billing & Revenue Operations Lead 2.9 2.9 out of 5 stars 1560 Main Street, Palmyra, ME 04965 Full-time Hometown Health Center 41 reviews Full-time The Billing Coordinator serves as the operational lead for all billing and revenue cycle activities for the health center. This role oversees end‑to‑end billing operations, ensures regulatory and payer compliance, manages billing and patient account staff, and partners closely with the CFO to support financial sustainability and organizational performance. The ideal candidate brings deep FQHC billing expertise, strong leadership skills, and the ability to analyze trends, implement process improvements, and proactively manage revenue risk in a complex healthcare environment. Essential Job Functions The Billing Coordinator performs the following duties, including but not limited to: Lead and oversee all daily billing and patient account operations, including charge entry, claim submission, payment posting, adjustments, refunds, and self‑pay/insurance collections. Ensure accurate and timely billing for Commercial, Medicaid, Medicare, and Medicare Advantage plans in compliance with payer, state, and federal requirements. Supervise, train, and support billing and patient account staff to ensure productivity, accuracy, and adherence to established policies and procedures. Develop, document, and continuously improve billing workflows and internal controls, coordinating efforts between clinical, front desk, billing, and external partners. Monitor claim denials, underpayments, and billing trends; lead root‑cause analysis and implement corrective actions to improve reimbursement and reduce preventable revenue loss. Maintain strict compliance with HRSA, FQHC, and UDS requirements, including sliding fee scale policies, self‑pay discounts, and documentation standards. Collaborate directly with the CFO on revenue cycle strategy, financial reporting, and operational priorities that impact cash flow and financial stability. Monitor accounts receivable aging, collection performance, and payer mix; develop and track Key Performance Indicators (KPIs) and actionable dashboards. Prepare and assist with monthly billing reports, EFT bank reconciliations, and month‑end close processes in coordination with Finance. Oversee coding compliance, maintaining expertise in CPT and ICD‑10 standards; provide guidance and education to staff regarding coding updates and payer changes. Participate in internal and external Evaluation and Management (E/M) coding audits, supporting documentation review, corrective actions, and ongoing compliance efforts. Review and approve patient and insurance refunds in alignment with organizational policy. Manage bad debt write‑off processes, ensuring accuracy of account balances, adjustments, and reporting. Ensure compliance with the No Surprises Act, including timely Good Faith Estimates and coordination of patient charges. Ensure adherence to organizational policies, HIPAA, 42 CFR, HRSA, FQHC guidelines, statutes, and contract requirements. Coordinate and lead monthly billing and patient account meetings to review performance, compliance, and operational challenges. Participate in quality assurance activities, compliance initiatives, and required organizational training. Qualifications Experience Minimum of 2-3 years of progressive medical billing experience in a Federally Qualified Health Center (FQHC). Demonstrated experience managing billing operations, denials, payer requirements, and compliance in a multi‑payer environment. Prior experience supervising or leading billing or patient account staff strongly preferred. Education High school diploma or equivalent required. Post‑secondary education in healthcare administration, business, finance, or a related field preferred. Medical Billing and Coding certification (e.g., CPC, CPB, CEMC) preferred or willingness to obtain within an established timeframe. Required Skills and Competencies Strong working knowledge of FQHC billing, sliding fee scale requirements, and UDS reporting. Advanced understanding of revenue cycle performance metrics and financial workflows. Ability to independently manage complex billing operations with minimal oversight. Analytical mindset with strong problem‑solving and process‑improvement skills. Proven leadership, coaching, and team development abilities. Excellent written and verbal communication skills, with the ability to collaborate effectively with Finance, Clinical, and Operations leadership. Proficiency in EHR and practice management/billing systems. Why Join Us This role offers an opportunity to serve as the senior operational leader for billing and revenue performance within a mission‑driven community health organization. The Billing Coordinator plays a critical role in ensuring access to care for patients while partnering closely with executive leadership to strengthen the organization's financial health.