Job Details

Clinic Revenue Manager

San Francisco Community Health Center is a Federally Qualified Health Center (FQHC) providing culturally competent, high-quality medical care, mental health services, education, and outreach. We are a safety-net for the LGBTQ community, the unsheltered community, people who use substances, and those with mental health needs. We are an anchor-organization for San Francisco's Tenderloin neighborhood and we also lead regional, statewide, and national programming. We believe that everyone deserves access to the highest quality care served with dignity and respect!

The Clinic Revenue Manager (CRM) is a highly visible role that takes control and forwards the financial flow of patient services at SFCHC, a Federally Qualified Health Center (FQHC). The CRM guarantees that appropriate information is collected, verified, and documented from the initial appointment to the final settlement of charges when bills are fully paid. The CRM is responsible for ensuring that all processes are efficient, adhering with regulatory standards yet removing barriers to person access to whole person care. Importantly, the CRM works to improve cash flow, minimize bad debt, reduce denials and no-shows enhance patient satisfaction and appointments. This position reports to the Director of Clinical Operations and works full time, on-site at the clinic location.

Essential Duties:

• Managing the revenue cycle: Leads coding, billing, collections, denial management, and financial reporting
• Clean claims are processed: Working with Ochin Billing Services [OBS], a 3rd party billing and collections services and Clinicians that charges are completed, coded correctly, signed off and submitted within 72 hours.
• Resolving billing issues: Working to resolve any billing-related issues flagged by OBS with the respective clinicians within 5 days
• Managing accounts receivables: Working to effectively manage accounts receivables and reduce over 60 days past dues
• Annual master fee schedule: Updates SFCHC master fee schedule and sliding fee discount table for April 1 implementation
• Staying apprised of trends: Staying current with coding and revenue trends
• Implementing coding changes: Implementing coding changes and providing coding education to staff
• Managing the team: Managing and supervising new patient enrollment, appointments, cancellations, insurance verification, eligibility, sliding fee, and works collaboratively with the ESA, ECM and program clients' support staff
• Reporting compliance and analyses: Creates provider productivity and utilization reports, weekly, monthly and year-to-date revenue analysis- charges, payments, adjustments and write-offs
• Related fiscal and compliance functions: PIP, risk pool inventive, capitation, wrap-around and credentialing and enrollment of new providers to DHCS-PAVE, CMS-PECOS and health plans
• Staff training and collaboration: Creates workflows, on-boarding and training of new staff, cross-functional training with allied services like ECM and programs
• Other duties as assigned

Qualifications, Training and Experience:

• A bachelor's degree in accounting, business administration, or related healthcare is a must
• Valid certification in medical/dental billing or coding or related certification
• 5-10 years of experience in medical billing, coding, eligibility and health insurance
• Community healthcare or federally qualified health clinic experience is highly desirable
• Experience managing claims to Medi-CAL, ECM, Medicare, commercial or private plans
• Knowledge of sliding fee discount programs and the 340b drug discount for uninsured self-pay and public health assistance
• Supervisory experience of 3-5 years
• Proficiency of HIPAA, PHI and patient rights
• Computer, analytical, and organizational skills

Benefits:

• Competitive compensation
• Comprehensive health, vision, and dental insurance
• Company sponsored life, and long-term disability insurance
• Generous paid time off including paid holidays
• Company-sponsored retirement plan
• Opportunities for professional growth and development

EEO Statement: San Francisco Community Health Center is an equal opportunity employer committed to identifying and developing the skills and leadership of people from diverse backgrounds. San Francisco Community Health Center does not discriminate on the basis of age, ancestry, citizenship status, color, creed, disability status, gender identity, HIV status, marital status, medical condition, genetic information, national origin, pregnancy, race, religion, sex, sexual orientation, veteran status, or any other legally protected class. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.