Manager Billing, Denials, Coding & Revenue Integrity
Yakima Valley Farm Workers Clinic Toppenish, WA Full-time Finance
Posted on May 12, 2023
YVFWC has a compulsory vaccination policy, including the Covid-19 primary series. The organization does not mandate the Covid-19 booster although it is offered through our employee health department. Medical and religious exemptions to the primary series will be considered and for those approved, the employee should anticipate following appropriate guidance around masking and other protective equipment offered.
The Manager Billing, Denials, Coding & Revenue Integrity will be responsible for overseeing charge entry and coding. Support increasing business profitability by ensuring accurate coding, analyzing and resolving denials, rejections/initiate best practices, and reduce days in accounts receivable. Provide leadership to the Billing, Coding and Denials Teams within the Corporate Billing department. Assists Vice President (VP) of Billing with designing procedures, policies and systems to maximize efficiency and accuracy functions under manager responsibility.
What We Offer
- Salary $76,000-$100,000 DOE with ability to go higher for highly experienced candidates (salary will be prorated if less than 1.0 FTE).
- 100% employer-paid health insurance for employees including Medical, Dental, Vision, Rx, 24/7 telemedicine; profit sharing, 403(b) retirement plan, generous paid time off, paid holidays, and more.
- Coaches, mentors and trains direct report staff. Provides continuous performance management and conducts employee performance evaluations. Addresses performance and/or behavior issues, clarifying expectations and providing feedback.
- Supports staff growth and development. Assesses the educational and experience needs of staff in collaboration with the individual. Encourages staff to seek educational opportunities incorporating job related training in addition to mandatory training.
- Participates in the recruitment and selection of staff. Provides orientation to outline job requirements and expectations, policies and procedures, and proper use of tools and equipment.
- Creates and maintains an inclusive work environment that respects diverse ideas, backgrounds, and styles. Supports diversity through the selection, management, and retention of diverse employees. Creates, drives, and maintains an employee engagement culture.
- Manages key performance indicators and data for department and provide reporting and action plans for improvement.
- Provides routine reporting to VP of Billing and organizational leadership.
- Identifies improvement opportunities and documents work-flow processes and procedures. When necessary, develops and implements policies to maintain proper workflow and accountability.
- Delegates to appropriate levels within the team.
- Familiarity with third party reimbursement methodologies. Communicates with A/R team and Senior Leadership on changes in managed care reimbursement and expectation of changes in insurance guidelines.
- Establishes payor performance communications to share in quarterly payor meetings, discerns when and how to escalate payer issues.
- Guides billing team to maintain strict adherence to write-off policies, Sliding Fee Discount, and other accounts receivable policies.
- Ensure billing team addresses issues identified by the clearing house are monitored and resolved.
- Oversee all aspects of billing activity and initiate appropriate corrective measures as needed. Communicates performance data and associated actions plans to Senior Leadership.
- Provides subject matter expertise regarding billing processes, policies and procedures to individuals inside and outside the department.
- Provides leadership to ensure staff meet established accuracy rate goals.
- Establishes continuing educational process to ensures coding team is current on appropriate reference materials including state, federal and payor billing guides.
- Creates on-going audit process that monitors coding compliance with regulations and established policies and procedures.
- Reviews and provides recommendations to Physician Coding Auditor for provider coding and documentation improvements.
- Denial Prevention
- Develop team to perform root cause analysis on denials and develop prevention strategies.
- Work across functional lanes to help prevent denials and improve claim adjudication including, but not limited to, insurance verification, patient registration, billing, coding identifying any workflow designs contributing to denials.
- Provides leadership for Billing and Coding to maximize efficiencies with charge entry, claim rejections and denials to reduce delays in claim adjudication and eliminate denials.
- Education: Associates Degree in Healthcare related field, four additional years (above required experience) in a directly related role may be substituted for the required education. Bachelor's Degree in Healthcare Information Management, Healthcare Administration, Business Administration or related field preferred.
- Experience: Five years of supervisory experience in Physician Revenue Cycle management department. At least 10 years' experience in clinical billing and/or coding environment. Proficiency with Epic Electronic Medical Records. Eight years of supervisory experience in Physician Revenue Cycle management department preferred. FQHC billing and coding experience preferred.
- Professional Licenses/Certificates/Registration Preferred: CPC (Certified Professional Coder) or Certified Coding Specialist (CCS) certification Certified Professional Biller (CPB)® certification. Certified Revenue Cycle Representative (CRCR), Certified Specialist Payment & Reimbursement (CSPR). RHIA, RHIT Certification.
- Knowledge/Skills/Abilities Required: Ability to effectively lead and manage a team. Ability to provide vision and leadership for the functional department and organization and create and implement strategy that aligns with organization goals. Ability to create and implement strategy that aligns with organization goals. Ability to influence others to achieve understanding, acceptance, and commitments to act in support of ideas, programs, and products. Ability to apply systems thinking and articulate the interconnections of various department activities to move the organization forward. Ability to delegate responsibilities and motivate staff to complete tasks. Strong collaboration skills with internal teams and external partnerships for the purpose of building alliances with key individuals or groups. Ability to write concise, organized, and clear communications to internal and external customers. Ability to develop effective working relationships to gain trust and establish credibility at all organizational levels. Leverages interpersonal skills and technical knowledge to bring people and ideas together to perform effectively. Ability to work effectively in a customer-oriented environment. Ability to effectively manage multiple, concurrent priorities. Aggregates and analyzes data in a way that is meaningful to business operations in a timely manner. Ability to conduct research into emerging technologies, products, trends, and standards and make recommendations to leadership.
We serve more than 197,000 patients across 28 medical clinics, 15 dental clinics, 11 pharmacies, and 49 program sites in two states. We are Level 3 Certified as a Patient-Centered Medical Home (PCMH). With integrated services including medical, dental, pharmacy, orthodontia, primary care nutritional counseling, autism screening, and primary care behavioral health, YVFWC's patient-centered model of care offers patients the full spectrum of care and shelter assistance, energy assistance, weatherization, HIV and AIDS counseling and testing, home visits, and four mobile medical/dental clinics.
Working at YVFWC
Working in our organization means being the passionate champion for those who have no voice. It means having the opportunity to work with underserved populations and with peers committed to the same work.
At Farm Workers Clinic
- We will consistently trust one another to work for the common good.
- We will foster integrity by demonstrating ethical behavior and insisting on doing what we say we will do.
- We will demonstrate transparency by being candid and truthful no matter the risk.
- We will create partnerships to strengthen ourselves and our community.
- We will fight for just treatment for all individuals.
- We will let joy in.
- We have the courage to be an agent of change and refuse anything short of excellence.
Our mission celebrates diversity. We are committed to equal opportunity employment