Hudson Valley Regional Community Health Centers (HVRCHC) is a Federally Qualified Health Center providing comprehensive health care services across primary care, mental health, dental, rehabilitation, and specialty services in Brewster, Poughkeepsie, and other regional locations.
The Medical Billing Specialist will manage the specialized submission, tracking, and reconciliation processes required for FQHC reimbursement. This role reports to the Director of Finance and works closely with the third-party billing service.
Key responsibilities include:
- Sending clean electronic or paper claims to Medicare, Medicaid, and commercial plans using the correct CPT, HCPCS, ICD-10, and revenue codes
- Applying FQHC-specific rates and wrap-around insurance logic, including sliding fee scale adjustments
- Researching claim rejections, unpaid claims, correcting errors, refiling unpaid accounts, and writing appeals as needed
- Recording insurance and patient payments, contractual adjustments, and credit accruals
- Following HRSA rules and coordinating with front-desk, HR, and clinical teams to resolve data issues
Requirements & Qualifications
- Previous experience in medical billing or revenue cycle management, ideally in an FQHC or community health setting
- Strong knowledge of Prospective Payment System (PPS), FQHC billing requirements, Medicaid/Medicare billing, and sliding fee scales
- Familiarity with EHR systems and practice management systems such as eClinicalWorks
- Understanding of HRSA compliance guidelines
- Certified Professional Biller (CPB) preferred
- 3 years of medical billing experience required
- 1 year of PSS/APM reimbursement model experience preferred
- 3 years of community health/FQHC experience preferred
- Medical billing certification preferred
- Strong attention to detail and excellent verbal and written communication skills
- Ability to work independently
Benefits & Perks
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Parental leave
- Retirement plan
- Competitive health, dental, and vision benefits
- Retirement savings plan
- Student loan forgiveness program eligibility (restrictions apply)
Location
New York, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$50,000 - $60,000
Remote work allowed
No
Posted
1 week ago