Billing & Coding Manager – FQHC Revenue Optimization (Contract-to-Hire)

Billing & Coding Manager – FQHC Revenue Optimization (Contract-to-Hire)

Location: Oakland, CA (In Person)
Pay Rate: $43.00/hour
Position Type: Contract-to-Hire

Role Overview

AlliedUP Cooperative is seeking a Revenue Cycle Subject Matter Expert to serve as Billing & Coding Manager for one of our FQHC clients. This role is purpose-built for a professional who specializes in maximizing reimbursement, reducing claim denials, and optimizing end-to-end FQHC billing workflows.

The ideal candidate is deeply fluent in FQHC reimbursement methodology, understands how to engineer clean claims upstream, and can quickly identify and correct leakage points across Epic and payer workflows. This is a hands-on, strategic role that blends operational execution, payer expertise, and provider partnership to materially improve financial outcomes while maintaining strict compliance.

Core Expertise We’re Looking For

• Expert-level knowledge of FQHC revenue cycle billing, including Medicaid PPS, Medicare FQHC payment rules, and managed care carve-outs

• Proven track record of reducing denial rates and increasing net reimbursement

• Ability to identify, diagnose, and correct root causes of claim rejections and underpayments

• Strong command of Epic billing workflows, claim edits, and reporting tools

• Comfortable serving as a go-to authority for billing, coding, and reimbursement strategy

Qualifications & Skills

• CPC, CCS, or equivalent professional coding certification (required)

• Bachelor’s degree in healthcare administration, business, or related field—or equivalent experience

• Minimum 3+ years of progressive experience in medical billing, coding, or revenue cycle management

  • FQHC or Community Health Center experience strongly preferred

• Advanced knowledge of:

  • FQHC billing and reimbursement models

  • Medicaid PPS, Medicare FQHC methodology, and managed care contracts

  • CPT, HCPCS, ICD-10 coding and modifier usage

• Demonstrated success in improving:

  • Clean claim rate

  • First-pass yield

  • Denial rate

  • Net collection rate

• High-level analytical skills with the ability to translate data into operational improvements

• Proficiency with Epic EHR required (Athena exposure a plus)

• Strong communicator able to partner effectively with providers, finance, and operations teams

• Commitment to healthcare equity and access

Billing Operations & Technical Expertise

• Daily hands-on experience with:

  • Charge Router

  • Claim edit and denial work queues

  • Remittance analysis and reconciliation

• Ability to:

  • Perform detailed denial root-cause analysis

  • Audit claims and identify reimbursement leakage

  • Resolve Epic configuration, build, or workflow issues in real time

• Experience building, monitoring, and refining revenue cycle KPIs, including:

  • Clean claim rate

  • First-pass resolution

  • Denial rate by payer and reason

  • Days in Accounts Receivable

• Skilled at designing workflows that improve billing outcomes without increasing provider burden

Key Responsibilities

Revenue Cycle Optimization

• Own and optimize the full revenue cycle lifecycle: charge capture, coding, claim submission, denial management, and collections

• Proactively identify and resolve issues impacting reimbursement accuracy and timeliness

• Implement best practices to improve clean claim performance and reduce preventable denials

Claims Accuracy & Denial Prevention

• Review provider documentation and charge entries to ensure accurate coding, modifier usage, and diagnosis alignment

• Perform pre- and post-billing audits to identify trends in denials and underpayments

• Develop corrective action plans to address systemic billing issues

Compliance & Regulatory Oversight

• Ensure all billing activities comply with:

  • FQHC regulations

  • Medicaid PPS and Medicare FQHC requirements

  • Payer-specific billing rules

• Serve as a compliance resource for billing and coding questions

Provider, Payer & Client Collaboration

• Partner closely with providers to strengthen documentation and coding practices that support optimal reimbursement

• Work directly with payers to resolve complex claim issues and payment discrepancies

• Support contract interpretation and payer discussions as needed

Data, Reporting & Strategic Insight

• Produce and analyze reports on:

  • Payer mix

  • Visit volumes

  • Coding and denial trends

  • Revenue and reimbursement performance

• Translate data insights into actionable workflow and process improvements

Financial Partnership

• Collaborate with the CFO, Controller, and revenue leadership to support:

  • Revenue forecasting

  • Budget planning

  • Long-term revenue cycle strategy

Why Join AlliedUP Cooperative

• Mission-Driven Impact: Play a direct role in strengthening financial sustainability for FQHCs serving underserved communities

• Expert-Level Work: Be trusted as a revenue cycle authority, not just an administrator

• Collaborative Culture: Work alongside leaders committed to equity, transparency, and continuous improvement

• Growth Opportunity: Contract-to-hire role with long-term leadership potential

• Competitive Compensation: $43/hour with benefits and professional development opportunities