CHARACTERISTICS OF THE WORK

Under the general direction of the Chief Financial Officer, manages the day-to-day supervision and processes associated with the medical billing function, including outsourced services. Responsible for ensuring the accurate and timely billing and collection of medical claims by monitoring and managing the Revenue Cycle Management (RCM) process.

EXAMPLES OF THE WORK

(These statements are intended to be illustrations of the work of this class.) Ensures billing and collection processes meet the organization's financial and operational goals, as well as the requirements for internal controls and third-party payors. Ensures billing and collection processes are compliant with state, local, and federal laws; regulations; and/or best practices. Reviews and oversees the submission of Center for Medicare and Medicaid Services (CMS-1500), also known as Health Care Financing Administration (HCFA), claims to the appropriate health plans weekly. Reviews claims denials for complexity and instructs appropriate staff to make changes and corrections to resubmit claims within 30 days of the denial received date. Performs quality control procedures on all claim forms and detail bills to ensure accurate billing. Verifies insurance benefits and contacts vendors regarding denials or benefit coverage. Runs all required billing reports. Maintains appropriate staffing levels for RCM processes. Updates annual clinic rate changes to Medicaid and Medicare Prospective Payment Systems. Develops and implements systems, mechanisms, controls, and reporting tools to monitor and ensure billing and collection efforts are functioning efficiently. Develops and maintains positive working relationships with patients, contractors, vendors, third-party payor resources, and related entities. Performs fee schedule analysis, rate setting, and maintenance. Loads and maintains procedure and diagnosis codes and performs related research as required. Researches new technologies and tools, recommending improvements to existing processes and supporting ongoing improvement of billing and collection efforts. Researches RCM clinical and grant programs to identify new programs or changes to existing programs. Assists administration in designing programs in the Practice Management Software (PMS). Supervises personnel, managing productivity, work assignments, and process improvement. Serves as a liaison for any outsourced RCM services. Performs related work as required.

MINIMUM REQUIREMENTS

Bachelor's degree in Healthcare Administration, Business, Accounting, Finance, or a closely related field. Three years of management experience in revenue cycle management, including experience in billing and collections. An equivalent combination of training and experience may be substituted as determined applicable by Civil Service.

PHYSICAL REQUIREMENTS AND WORKING CONDITIONS

Responds to patient and FHC needs via telephone, internet, fax, computer software, and in person. Lifts and carries materials weighing up to 15 lbs. Spends extended periods of time sitting, typing, and reading computer screens.

SPECIAL REQUIREMENTS

Must be available to work extended hours, including before or after regularly scheduled hours and weekends, as necessary. Must provide own transportation to work at other locations as needed.

An Equal Opportunity Employer Test Weights Training & Experience:

100% Please note that Training & Experience scores are based on the relevant (as determined by the hiring agency and Civil Service) training and experience, as listed on your application and/or resume, as submitted here. Any information that is unclear or that is not listed on your application and/or resume will not be considered in the calculation of the Training & Experience score. This also means that you should list your employment dates, including the month and year (i.e., 02/2022 to 08/2025) of employment, as well as the number of hours worked per week.

CLINIC LOCATIONS AND HOURS

www.fhclouisville.org FHC

• Portland 2215 Portland Avenue Louisville

KY 40212

(502) 774-8631 Monday

• Thursday:

  8:00am
• 9:00pm

Friday:

8:00am

• 4:30pm

Saturday:

8:00am

• noon

Sunday:

Closed FHC

• East Broadway 834 East Broadway Louisville

KY 40204

Monday

• Thursday:

  8:00am
• 9:00pm

Friday:

8:00am

• 4:30pm

Saturday:

8:00

• 12:00pm

Sunday:

Closed FHC

• Phoenix (Healthcare for the Homeless) 712 E Muhammad Ali Blvd Louisville

KY 40202

Monday

• Friday:

  7:30am
• 4:00pm Saturday

• Sunday:

  Closed FHC
• Iroquois 4100 Taylor Blvd Louisville

KY 40215

Monday:

8:00am

• 4:30pm

Tuesday:

8:00am

• 8:30pm Wednesday

• Friday:

  8:00am
• 4:30pm Saturday

• Sunday:

  Closed FHC
• Fairdale 1000 Neighborhood Place Fairdale

KY 40118

Monday

• Friday:

  8:00am
• 4:30pm

Thursdays:

8:00am

• 8:30pm Saturday

• Sunday:

  Closed FHC
• Southwest 9702 Stonestreet Road, Suite 220 Louisville

KY 40272

Monday

• Wednesday:

  8:00am
• 4:30pm

Thursday:

8:00am

• 8:00pm

Friday:

8:00am

• 4:30pm Saturday

• Sunday:

  Closed FHC
• Americana 4805 Southside Drive Louisville

KY 40214

Monday

• Friday:

  8:00am
• 4:30pm Saturday

•

Sunday:

Closed