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City of Baltimore · 2 months ago

RCM Billing and Reimbursement Manager II, Grant Service Specialist III (NCS) - Baltimore City Health Department

1001 E Fayette St

Full-time

Onsite

Senior Level

$64K/yr - $111K/yr

6+ years exp

The City of Baltimore is committed to social impact and community service, and they are seeking an RCM Billing and Reimbursement Manager II to oversee programs within the Bureau of Maternal Child Health. The role involves managing medical billing processes, resolving claims issues, and providing excellent customer service to community partners and internal teams.

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Responsibilities

Responsible for assigned programs within the Bureau of Maternal Child Health (MCH)

Daily work activities include medical billing charge capture, patient enrollment demographics, patient eligibility and claims submission

Identifying workflow bottlenecks and solutions

Resolving claims rejections/denials, ensuring clean data and claims are entered into state systems and practice management portals

Be a subject matter expert in billing / reimbursement guidelines for the Bureau of MCH and Maryland Medicaid

Reconcile all charges, patient enrollment data/ demographics, reimbursements, claims denials to prepare month end reports and maintain RCM dashboard

Provide excellent customer service to our community partners, parents, and internal cross-functional teams

Qualification

Medical billing experienceRevenue Cycle ManagementEPIC EMR/PMCPTICD-10 codingClaims processingCustomer serviceData entryReport generationPatient communicationTeam collaboration

Required

Must have verifiable 6 or more years hands on experience in working knowledge with medical claims clearinghouse

Must have verifiable 6 or more years hands on experience in charge capture

Must have verifiable 6 or more years hands on experience in processing & submitting claims, and resolving claim denials

Must have verifiable 6 or more years hands on experience in patient communication - verifying patient insurance - data entry

Must have verifiable 6 or more years hands on experience in generating monthly reports / maintaining billing dashboard / ad-hoc reports

Must have verifiable 6 or more years hands on experience in revenue cycle management integrity

Must have verifiable 6 or more years hands on experience in resolving A/R discrepancies - claim denials management

Must have verifiable 6 or more years hands on experience in timely filing guidelines - Medicaid, Medicare, third party billing guidelines

Must have verifiable 6 or more years hands on experience in interpreting EOBs, payer remits from various insurance payers

Must have verifiable 6 or more years hands on experience in working knowledge of CPT and ICD-10 code application

Education: Have a bachelor's degree from an accredited college or university

Experience: Have six (6) years of experience in medical billing and reimbursement in a physician office or group setting

Must have previous experience with physician billing system

Must have previous experience with MS Office products (Word, Excel, Outlook)

EPIC EMR/PM - REQUIRED

Have an equivalent combination of education and experience. Ten (10) years medical billing and reimbursement/ revenue cycle management accepted in lieu of BA degree

Must be able to read, write, and speak the English language in an understandable manner

Must be able to work independently and possess the ability to make independent decisions when circumstances warrant such action

Must possess the ability to effectively communicate and deal tactfully with other personnel, visitors, patients, physicians, customers, and the general public

Must be flexible, have personal integrity, and the ability to function effectively as a team with other employees

Must be able to follow written and oral instructions