-Assistant Billing Manager

Job Summary

The Assistant Billing Manager supports the Billing Manager in overseeing the daily operations of the billing and revenue cycle functions of the Federally Qualified Health Center (FQHC). This position assists in ensuring accurate and timely claim submission, payment posting, insurance follow-up, denial resolution, accounts receivable management, and compliance with applicable federal and state regulations, payer requirements, and organizational policies.

The Assistant Billing Manager plays an important role in maximizing reimbursement, improving revenue cycle performance, supporting staff development, and ensuring that billing practices align with FQHC reimbursement methodologies, including Prospective Payment System (PPS) requirements and applicable Medicaid wraparound payment processes. This position works collaboratively with clinical operations, patient access, credentialing, finance, and other departments to support the organization's financial sustainability and mission of providing quality, accessible healthcare.

Qualifications / Requirements

- Associate degree in healthcare administration, business administration, accounting, or a related field preferred or equivalent experience.

- Three to five years of medical billing, healthcare revenue cycle, or claims management experience preferred.

- Prior experience in a supervisory, lead, or senior billing role preferred.

- Experience with FQHC billing, Medicare and Medicaid reimbursement, managed care organizations, and PPS methodologies strongly preferred.

- Experience with denial management, accounts receivable follow-up, claims appeals, and revenue cycle reporting required or strongly preferred.

- Knowledge of medical billing procedures, insurance claims processing, reimbursement methodologies, and payer requirements.

- Strong analytical, problem-solving, organizational, and time-management skills.

- Ability to review financial and operational reports, identify trends, and recommend corrective actions.

- Demonstrated ability to train, coach, and support team members.

- Strong written and verbal communication skills.

- Proficiency in Microsoft Office, particularly Excel, and experience with electronic health record and practice management billing systems.

- Ability to manage competing priorities while maintaining accuracy and meeting deadlines.

- Commitment to confidentiality, ethical billing practices, regulatory compliance, and the organization's mission.

Essential Functions

- Assist the Billing Manager with the daily oversight of billing operations to ensure claims are submitted accurately and within established filing deadlines.

- Monitor claim submission, payment posting, insurance follow-up, denial management, and accounts receivable activities.

- Review billing workflows to identify errors, inefficiencies, and opportunities for improvement.

- Help ensure claims are supported by complete and accurate documentation, appropriate coding, and applicable payer requirements.

- Monitor unbilled encounters and work with clinical and operational teams to resolve outstanding documentation or charge-entry issues.

- Support compliance with FQHC-specific billing and reimbursement requirements, including Medicare and Medicaid billing guidelines and applicable PPS or alternative payment methodologies.

- Ensure billing staff follow payer-specific requirements, including authorization, eligibility, credentialing, coding, and claim submission guidelines.

- Monitor denial trends and assist in developing corrective action plans to reduce preventable denials.

- Ensure denied and rejected claims are reviewed, corrected, appealed, and resubmitted within required timeframes.

- Review aging accounts receivable and prioritize follow-up based on outstanding balances, payer, aging category, and collection opportunities.

- Assist the Billing Manager with assigning, monitoring, and reviewing the work of billing staff.

- Provide day-to-day guidance, technical assistance, and support to billing team members.

- Train new hires on billing procedures, payer requirements, systems, workflows, and departmental expectations.

- Support ongoing staff education regarding coding updates, payer policy changes, denial prevention, and FQHC billing requirements.

- Assist with monitoring productivity, accuracy, and adherence to established departmental standards.

- Identify opportunities to improve collections, reduce rework, increase clean claim submissions, and shorten the revenue cycle.

- Support the development and implementation of standardized workflows and performance improvement initiatives.

- Communicate significant billing issues, trends, and opportunities for improvement to the Billing Manager.

- Serve as a resource for billing staff and provide operational support in the Billing Manager's absence, as assigned.

- Perform other duties as assigned to support the department and the organization.

Physical Requirements

This position primarily operates in an office or healthcare administrative environment. The role requires extended periods of computer use, communication with staff and external partners, and the ability to review and analyze detailed financial and billing information. Reasonable accommodations may be made to enable qualified individuals to perform the essential functions of the position.