The MetroHealth System (Cleveland, OH)
Mgr FQHC Billing & Revenue Integrity-Ar Management (Prof)
The MetroHealth System (Cleveland, OH), Cleveland, Ohio, us, 44101
Job Overview
MetroHealth System – Old Brooklyn Campus, Cleveland, OH
Biweekly Hours:
80.00
Shift:
8:00 am – 5:00 pm
The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well‑being. Founded in 1837, the system operates four hospitals, four emergency departments and more than 20 health centers across Cuyahoga County.
Summary Maintains the integrity of the revenue capture system across Federally Qualified Health Centers (FQHC) locations. Focuses on maximizing collections by accurately capturing all charges and implementing charge capture processes. Works closely with clinical departments to align processes with governmental, payer, and internal charge capture policies; provides education to clinical staff. Utilizes knowledge of governmental and third‑party payer regulations, billing, and reimbursement processes. Assists in coordinating and overseeing all activities related to collections and accounts receivable management. Ensures all activities related to collection functions include claim status, denial management, aged account follow‑up, and resolution. Coordinates with other revenue management functions to meet customer requirements, maximize revenue collection, and achieve best‑practice targets. Upholds the mission, vision, values, and customer service standards of The MetroHealth System.
Required Qualifications
Bachelor’s Degree, preferably in Accounting, Finance or Healthcare Management.
In lieu of a Bachelor’s degree, acceptance of Certified Professional Coder (CPC).
4+ years of experience with EPIC and/or a major industry standard billing system.
Financial analytical experience in a healthcare environment.
Demonstrated experience with FQHC revenue cycle operations.
Knowledge of healthcare revenue cycle practices.
Ability to manipulate and analyze data derived from disparate source systems.
Advanced knowledge of MS Excel, Access, PowerPoint and query tools for creating reports and financial models.
Excellent time‑management and project‑prioritization skills with the ability to multi‑task.
Detail‑oriented and able to work independently.
Strong written and verbal communication and interpersonal skills.
Ability to facilitate group meetings and interview sessions.
Knowledge of third‑party billing requirements and Coordination of Benefits (COB).
Analytical aptitude and ability to translate functional needs to an integrated technical/professional computerized environment.
Preferred Qualifications
Progressive management experience.
MBA/MPH/MHA/MHS or other certification such as CPA.
Certification in billing and coding represented by RHIA, RHIT, RN, CPC, COC, CCS, or CCS‑P.
High level of quantitative and qualitative research, analytical skills and critical thinking skills with expertise to drive process development to implementation.
Physical Demands
May need to move around intermittently during the day, including sitting, standing, stooping, bending, and ambulating.
May need to remain still for extended periods, including sitting and standing.
Ability to communicate in face‑to‑face, phone, email, and other communications.
Ability to read job‑related documents.
Ability to use computer.
Additional Information
Seniority Level:
Mid‑Senior level
Employment Type:
Full‑time
Job Function:
Accounting/Auditing and Finance
Industry:
Hospitals and Health Care
#J-18808-Ljbffr
Biweekly Hours:
80.00
Shift:
8:00 am – 5:00 pm
The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well‑being. Founded in 1837, the system operates four hospitals, four emergency departments and more than 20 health centers across Cuyahoga County.
Summary Maintains the integrity of the revenue capture system across Federally Qualified Health Centers (FQHC) locations. Focuses on maximizing collections by accurately capturing all charges and implementing charge capture processes. Works closely with clinical departments to align processes with governmental, payer, and internal charge capture policies; provides education to clinical staff. Utilizes knowledge of governmental and third‑party payer regulations, billing, and reimbursement processes. Assists in coordinating and overseeing all activities related to collections and accounts receivable management. Ensures all activities related to collection functions include claim status, denial management, aged account follow‑up, and resolution. Coordinates with other revenue management functions to meet customer requirements, maximize revenue collection, and achieve best‑practice targets. Upholds the mission, vision, values, and customer service standards of The MetroHealth System.
Required Qualifications
Bachelor’s Degree, preferably in Accounting, Finance or Healthcare Management.
In lieu of a Bachelor’s degree, acceptance of Certified Professional Coder (CPC).
4+ years of experience with EPIC and/or a major industry standard billing system.
Financial analytical experience in a healthcare environment.
Demonstrated experience with FQHC revenue cycle operations.
Knowledge of healthcare revenue cycle practices.
Ability to manipulate and analyze data derived from disparate source systems.
Advanced knowledge of MS Excel, Access, PowerPoint and query tools for creating reports and financial models.
Excellent time‑management and project‑prioritization skills with the ability to multi‑task.
Detail‑oriented and able to work independently.
Strong written and verbal communication and interpersonal skills.
Ability to facilitate group meetings and interview sessions.
Knowledge of third‑party billing requirements and Coordination of Benefits (COB).
Analytical aptitude and ability to translate functional needs to an integrated technical/professional computerized environment.
Preferred Qualifications
Progressive management experience.
MBA/MPH/MHA/MHS or other certification such as CPA.
Certification in billing and coding represented by RHIA, RHIT, RN, CPC, COC, CCS, or CCS‑P.
High level of quantitative and qualitative research, analytical skills and critical thinking skills with expertise to drive process development to implementation.
Physical Demands
May need to move around intermittently during the day, including sitting, standing, stooping, bending, and ambulating.
May need to remain still for extended periods, including sitting and standing.
Ability to communicate in face‑to‑face, phone, email, and other communications.
Ability to read job‑related documents.
Ability to use computer.
Additional Information
Seniority Level:
Mid‑Senior level
Employment Type:
Full‑time
Job Function:
Accounting/Auditing and Finance
Industry:
Hospitals and Health Care
#J-18808-Ljbffr