Description

Join Elica’s mission and become a part of a team where every day is an opportunity to make a positive impact in your community!

At Elica Health Centers, we share a common goal: provide the best possible patient care to our growing community! Our passion extends throughout Elica, from the exceptional healthcare services we provide to our underserved patients at our Community Health Clinics and state-of-the-art mobile medicine program, Health on Wheels, to our Resource Center where we empower patients and members of the community to connect with resources to help them build healthy and full lives.

What You'll Do:

The FQHC Billing & Financial Services Manager is responsible for ensuring maximum effectiveness of Elica’s billing operations. This includes assisting with the development and coordination of implementation initiatives that ensure consistency and quality of the coordination of billing processes, procedures, and best practices for all phases of Elica’s Billing Department. This position oversees Elica’s billing functions including the billing and collections of patient accounts, compliance with third-party payer regulations, cash posting, staff productivity and ongoing improvement to key revenue cycle indicators. These key indicators include but are not limited to: days revenue in A/R, paid claims percentage, managing denied claims, timely billing, clean claims, etc.

The FQHC Billing & Financial Services Manager reports directly to the Controller and collaborates closely with key strategic internal partners within Elica including: CFO/COO, Revenue Cycle Operations Manager, Program & Operations Directors, Process Improvement Engineers, and Site Managers.

Essential Job Functions:

• Manage a team of billing and coding specialists, providing guidance, training, and support to ensure accurate and timely billing processes.
• Work closely with finance and clinic personnel to optimize billing procedures and address any billing-related concerns. Engage in clear and effective communication with healthcare providers, insurance entities, and patients to manage billing inquiries and resolve disputes promptly
• Monitor billing benchmarks and standards of practices with policies and procedures consistent with organizational goals, infrastructure, and federal and state requirements.
• Plan and allocate resources to effectively staff and accomplish the work to meet departmental productivity and quality goals.
• Monitor billing data and trends, identify improvement areas, and implement solutions to enhance billing performance
• Conduct regular audits of billing records to ensure accuracy and compliance with regulatory requirements. Also, the findings should be communicated to appropriate team members.
• Develops a system of reporting, dashboards, and key performance indicators to provide meaningful information for appropriate staff.
• Consistently explores opportunities for enhancing the execution and assistance of all billing processes and operations.
• Manage the accuracy and timely posting of payments, adjustments, and write-offs in EPIC according to Elica’s policy and procedures
• Analyze and reconcile financial reports with accounting to ensure accurate, complete, and consistent information.
• Maintains required billing records, reports, files.
• Assist with coding and error resolution.
• Oversee the development, maintenance, implementation, and training of policies, procedures, and workflows for all functions related to billing.
• Assist the Billing Managers with internal management of the department staff.
• Coach, mentor, and develop staff, including overseeing new employee onboarding and providing career development planning and opportunities.
• Stay updated on changes in healthcare billing regulations and requirements, and ensure that billing practices remain in compliance with current standards.
• Communicate effectively with healthcare providers, insurance companies, and patients to address billing inquiries and resolve billing disputes.
• Intentionally cultivate a workplace culture aligned with the organization's overall mission and values, emphasizing the identified mission and values of the organization.
• Carry out any additional responsibilities as required

Requirements

Education and Licensing Requirements:

• Bachelor’s Degree required; MBA preferred. Equivalent experience may be considered in place of education requirements.
• Minimum 5 years of billing & coding experience within the healthcare industry. FQHC experience is highly preferred.
• A minimum of three years of responsible leadership experience in management or supervisory positions overseeing the work of a group of people.
• Familiarity with multiple EHRs and Practice Management Systems helpful. Experience with Epic preferred.
• Extensive knowledge of Medi-Cal, Medicare, and Managed Care required.
• Demonstrable billing experience within the areas of billing, coding, insurance verification, eligibility for benefits, reimbursement, payment posting, denials management, healthcare technology, customer service, counseling, teaching/education, health provider front and back office, and experience with associated online payer systems.

Essential Skills/Abilities:

• Ability to foster a spirit of teamwork and unity among department members that allows for disagreement over ideas, conflict and expeditious conflict resolution, and the appreciation of diversity as well as cohesiveness, support, and working effectively together to enable each employee and the department to succeed.
• Powerful leadership skills with the ability to coach and mentor teams through periods of high growth
• Knowledge and experience in business, supervision, and management.
• Knowledge of the functions, operation, and mission of the specific department.
• Better than average written and spoken communication skills.
• Outstanding interpersonal relationship building and employee coaching and development skills.
• Demonstrated ability to serve as a knowledgeable resource to the organization's management team that provides leadership and direction.
• Strong computer skills particularly with Microsoft Office (Excel, Word, PowerPoint) and Google Workspace.
• Strong analytical skills with the ability to identify trends and present information in a succinct and actionable manner.
• Creative problem-solving skills with the ability to multitask and prioritize business requirements in a dynamic, fast-paced environment.
• Ability to think and work creatively and effectively in a rapidly changing environment.

Benefits:

Elica is proud to offer an exciting benefits package to qualifying full-time employees which can support your health, your family, and help you plan for the future.

• 403B retirement savings account with up to 4% employer matching contribution and 100% immediate vesting.
• Healthcare: Medical (Kaiser or Anthem Blue Cross PPO), Dental, Vision - Individual and family plans available
• Company funded Health Reimbursement Arrangement (HRA) to help pay for out-of-pocket costs related to medical coverage
• FSA Plans: 2 options for Flexible Spending Accounts - Health Care FSA and Dependent Care FSA
• Company paid basic Life and AD&D Insurance. (supplemental life and AD&D options available)
• Optional Critical Illness, Accident, ID Theft Protection and Pet insurance options
• Accrued paid time off and paid holidays.
• Employee Assistance Plan with five (5) free counseling visits, financial services, legal services, and a plethora of online resources.
• Tuition Reimbursement program and CME/CEU program.

Learn more about Elica’s services and mission at our website or check us out on Facebook.

Physical Requirements and Work Environment:

The work environment is characteristic of normal office conditions. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is frequently required to sit; use hands to handle or lift. The employee is occasionally required to stand; walk; and reach with hands and arms. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus. The employee must also possess hearing and speech to communicate in person and over the phone. The noise level in the work environment is usually quiet. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Additional Requirements:

• Must have a current and valid California driver’s license and the ability to provide proof of personal auto insurance on the vehicle driven during working hours.
• If selected for an employment opportunity with Elica Health Centers, external hires must provide proof of immunizations (Hepatitis B, MMR, Varicella & Tetanus), tuberculosis clearance, and proof of COVID-19 vaccination status* prior to their scheduled start date. Please be advised that this position is subject to criminal background investigation and drug screen.

*Elica Health Centers is a healthcare facility that adheres to the mandates issued by the California Department of Public Health including the recent orders regarding the COVID-19 vaccine. Medical and religious exemptions will be considered.