FQHC Billing Account Manager
Nexus HR, Santa Fe Springs, CA, United States
FQHC Billing Account Manager - Santa Fe Springs, CA
Compensation: $30 - $34 per hour
Nexus HR is seeking an experienced RCM Billing Account Manager. The ideal candidate will have a strong background in FQHC medical billing, revenue cycle management, and coding compliance. This role requires deep knowledge of payer regulations and reimbursement models, as well as leadership experience managing billing teams. Strong communication, analytical, and organizational skills are essential for success in this position.
About the Job The RCM Billing Account Manager is responsible for overseeing all aspects of Revenue Cycle Management (RCM), including billing operations, coding compliance, claims submission, denial management, and reimbursement optimization for FQHC clients. The role involves managing assigned accounts, supervising billing teams, and reporting directly to the RCM Division Manager. The schedule is Monday through Friday, 8:30 AM to 4:30 PM Pacific Standard Time, and will work on-site at the client's office as a representative.
Duties and Responsibilities
Oversee end-to-end billing and RCM operations for assigned FQHC accounts
Communicate with clients and respond to inquiries within one business day
Serve as a trusted advisor on FQHC billing rules, UDS reporting, wraparound payments, PPS/APM reimbursement models, sliding fee schedules, and Medicaid/Medicare billing
Monitor key RCM metrics such as clean claim rate, days in A/R, denial trends, and collection performance
Conduct monthly or quarterly business reviews (QBRs) with clients
Collaborate with internal billing teams and clearinghouses to ensure accurate claims submission, payment posting, and denial resolution
Ensure compliance with HRSA, CMS, and payer-specific billing guidelines
Maintain knowledge of state Medicaid programs and managed care plans
Create dashboards and KPI reports to track AR aging, charge lag, clean claim rate, and payment trends
Lead and manage billing staff, set goals, delegate tasks, monitor performance, and training
Ensure accurate and compliant coding practices following CPT, ICD-10, and HCPCS guidelines
Develop transition plans for team changes and support onboarding of new clients/projects
Qualifications
Minimum of 3 years of FQHC medical billing experience and 3 years of management experience
Associate’s or Bachelor’s degree preferred (or equivalent experience)
CPC (Certified Professional Coder) required
Strong leadership, client communication, KPI reporting, and RCM process optimization skills
Extensive knowledge of FQHC billing regulations, Medicaid/Medicare billing, PPS/APM reimbursement models, HRSA, and CMS guidelines
English proficiency required
Must be authorized to work in the United States
Benefits
401(k)
Medical Insurance
Dental Insurance
Vision Insurance
Paid Time Off (PTO)
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Nexus HR is seeking an experienced RCM Billing Account Manager. The ideal candidate will have a strong background in FQHC medical billing, revenue cycle management, and coding compliance. This role requires deep knowledge of payer regulations and reimbursement models, as well as leadership experience managing billing teams. Strong communication, analytical, and organizational skills are essential for success in this position.
About the Job The RCM Billing Account Manager is responsible for overseeing all aspects of Revenue Cycle Management (RCM), including billing operations, coding compliance, claims submission, denial management, and reimbursement optimization for FQHC clients. The role involves managing assigned accounts, supervising billing teams, and reporting directly to the RCM Division Manager. The schedule is Monday through Friday, 8:30 AM to 4:30 PM Pacific Standard Time, and will work on-site at the client's office as a representative.
Duties and Responsibilities
Oversee end-to-end billing and RCM operations for assigned FQHC accounts
Communicate with clients and respond to inquiries within one business day
Serve as a trusted advisor on FQHC billing rules, UDS reporting, wraparound payments, PPS/APM reimbursement models, sliding fee schedules, and Medicaid/Medicare billing
Monitor key RCM metrics such as clean claim rate, days in A/R, denial trends, and collection performance
Conduct monthly or quarterly business reviews (QBRs) with clients
Collaborate with internal billing teams and clearinghouses to ensure accurate claims submission, payment posting, and denial resolution
Ensure compliance with HRSA, CMS, and payer-specific billing guidelines
Maintain knowledge of state Medicaid programs and managed care plans
Create dashboards and KPI reports to track AR aging, charge lag, clean claim rate, and payment trends
Lead and manage billing staff, set goals, delegate tasks, monitor performance, and training
Ensure accurate and compliant coding practices following CPT, ICD-10, and HCPCS guidelines
Develop transition plans for team changes and support onboarding of new clients/projects
Qualifications
Minimum of 3 years of FQHC medical billing experience and 3 years of management experience
Associate’s or Bachelor’s degree preferred (or equivalent experience)
CPC (Certified Professional Coder) required
Strong leadership, client communication, KPI reporting, and RCM process optimization skills
Extensive knowledge of FQHC billing regulations, Medicaid/Medicare billing, PPS/APM reimbursement models, HRSA, and CMS guidelines
English proficiency required
Must be authorized to work in the United States
Benefits
401(k)
Medical Insurance
Dental Insurance
Vision Insurance
Paid Time Off (PTO)
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