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

THIS IS A NON-CIVIL SERVICE POSITION

Salary Range:

$64,427.00 - $110,756.00 Annually

Starting Pay:

$64,427.00 Annually

Get to Know Us

Welcome to the City of Baltimore! Experience the reward of a fulfilling career and enjoy the added element of excitement in a vibrant, diverse atmosphere. The City of Baltimore offers limitless opportunities to help drive social impact, both on the job and in the community, while serving its citizens. Join us in making Baltimore a great place to live and work. In the City of Baltimore, we hire great people and provide them with the skills and opportunities to grow toward their career aspirations. If you are looking for a career change or interested in learning more, explore our opportunities and benefits programs. We are excited to have you as a part of the City of Baltimore Team! The city offers medical, prescription drug, dental, vision, optional life, AD&D, and FSA plans. This office also supplies wellness programs, support groups, and workshops. You can learn about our benefits here: https://humanresources.baltimorecity.gov/hr-divisions/benefits  

NOTE: GRANT POSITIONS ARE NOT ELIGIBLE FOR RETIREMENT BENEFITS 

Job Summary:  

Under the supervision of the Director, Revenue Cycle Management. RCM Billing and Reimbursement Manager II is responsible for assigned programs within the Bureau of Maternal Child Health (MCH); in both a hands-on and leadership role for Baltimore City Health Department (BCHD). In the role of RCM Billing and Reimbursement Manager II, 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. RCM Billing and Reimbursement Manager II will reconcile all charges, patient enrollment data/ demographics, reimbursements, claims denials to prepare month end reports and maintain RCM dashboard. RCM Billing and Reimbursement Manager II will provide excellent customer service to our community partners, parents, and internal cross-functional teams.

Essential Functions:

Must have verifiable 6 or more years hands on experience in:

• Working knowledge with medical claims clearinghouse
• Charge capture
• Processing & Submitting Claims, and Resolving Claim Denials
• Patient Communication - Verifying Patient Insurance - Data Entry
• Generating monthly reports / maintaining billing dashboard / Ad-hoc reports
• Revenue Cycle Management integrity
• Resolve A/R discrepancies - Claim denials management
• Timely filing guidelines - Medicaid, Medicare, third party billing guidelines
• Interpreting EOBs, payer remits from various insurance payers
• Working knowledge of CPT and ICD-10 code application

Must have verifiable 6 or more years hands on experience in:

• Working knowledge with medical claims clearinghouse
• Charge capture
• Processing & Submitting Claims, and Resolving Claim Denials
• Patient Communication - Verifying Patient Insurance - Data Entry
• Generating monthly reports / maintaining billing dashboard / Ad-hoc reports
• Revenue Cycle Management integrity
• Resolve A/R discrepancies - Claim denials management
• Timely filing guidelines - Medicaid, Medicare, third party billing guidelines
• Interpreting EOBs, payer remits from various insurance payers
• Working knowledge of CPT and ICD-10 code application

Minimum Qualifications:     

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

AND 

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 and previous experience with MS Office products (Word, Excel, Outlook).

EPIC EMR/PM - REQUIRED

OR 

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

Knowledge, Skills, & Abilities: 

• Must be able to read, write, and speak the E