POSITION SUMMARY

The Billing Specialist is responsible to work collaboratively across teams and with external partners to optimize resources in support of program goals with a specific focus on health center revenue cycle supports.

The position will assist in the resolution of billing and other revenue cycle challenges with health plans and the state Medicaid agency, provides proactive and responsive technical assistance and training related to health center financial management, payment and revenue cycle operations, and develop tools and resources for health centers in relation to payment and revenue cycle challenges and opportunities.

RESPONSIBILITIES AND DUTIES

• 1. Provides technical assistance, training, education, and ongoing support to Health Centers in assigned areas.
  • a. Coordinates MPCA training events, meetings, webinars and conference calls to support Health Centers in building, maintaining and sustaining programs.
  • b. Identifies and develops educational and training opportunities for improvement to advance financial management, payment and revenue cycle knowledge and skills.
  • c. Facilitates peer networks of Health Center staff to build support and share resources among network members.
  • d. Provides technical assistance via email, phone, conference call and on-site visits to Health Center locations (as needed) to answer questions and resolve barriers to support Health Center projects.
  • e. Monitors and tracks billing issues to identify problem areas in which state advocacy may be needed.
  • f. Responds to requests for information from health centers which may require research, analysis and interpretation, as requested.
  • g. Networks with federal, state and local partners to build and maintain partnerships and monitor infrastructure and policy.
  • h. Participates in and provides resources for collaborative meetings and engagements with program stakeholders.
  • i. Interfaces with other MPCA programs to capture best practices and make content available to members in the form of briefs, webinars, and/or conference sessions.
• 2. Monitors program goals and deliverables
  • a. Develops and maintains dashboards for program performance and individual health center performance.
  • b. Develops and implements methods and procedures for monitoring work activities in order to keep management informed of current overall quality status including identified improvement opportunities.
  • c. Assists in assessments and reporting projects, as required.
• 3. Other duties as assigned.

KNOWLEDGE, SKILLS AND ABILITIES

Knowledge of:

• ICD-10, HCPCS and CPT coding systems.
• FQHC revenue cycle operations and reimbursement systems.
• Health insurance programs, coverage offered and third-party reimbursement mechanisms, including Medicare and Medicaid.
• Electronic medical record and automated billing systems.
• Word processing, spreadsheets, data base software, and the use of electronic communication technology.

Skill/Ability:

• Ability to collect, analyze, compile and interpret technical and/or statistical data
• Ability to interpret policies and procedures
• Ability to use initiative and independent judgment within established procedural guidelines
• Works independent and as a team member with minimal supervision
• Ability to communicate complex and technical information in a clear and concise manner, both verbally and in writing.

Education/Experience:

• Bachelor’s Degree preferred or 1-3 years of related work experience with High School Diploma required
• 1 + years of experience in medical billing required.
• Experience in A FQHC preferred MPCA DIVERSITY, EQUITY, AND INCLUSION STATEMENT

MPCA is committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion. Our human capital is our most valuable asset. The collective sum of our individual differences, life experiences, knowledge, inventiveness, innovation, self-expression, unique capabilities, and talent that our employees invest in their work, represents a significant part of our culture, our reputation, and success. We embrace and encourage our employee’s differences in age, color, ability ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, race, religion, sexual orientation, socio-economic status, veteran status, and in other characteristics that are both protected, and not protected by state or federal law. We are committed to leading by example and maintaining an equitable and inclusive work environment built on mutual respect and integrity.