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Billing & Claims Supervisor
3 months ago
**$75,000 - $88,000 annually**
Join Be Well OC / Mind OC in our mission to build a world-class mental health care system, that is accessible, compassionate, collaborative, and empowering.
We are currently seeking a Billing & Claims Supervisor to oversee billing staff and claims processing for services provided to clients facing mental health and substance use crisis care. This individual will oversee billing and claims submission to MediCal (via the county’s billing system IRIS) as well as third-party health plans. The Billing & Claims Supervisor is responsible for following up on billed claims, timely input of billable charges, resolving billing edit reports, working denied claims and processing payments. The Billing & Claims Supervisor will communicate and model effective resolution with culturally diverse clients in resolving past due accounts for mental health and substance use disorder services.
**Essential Functions**:
- Responsible for planning, organizing, and supervising staff engaged in processing and billing patients and fiscal intermediaries for health/medical services rendered to patients; daily review of claims and troubleshooting of claims in claim edit and daily/weekly reports for management.
- Reviews, analyzes, evaluates, and monitors various fiscal reports and remittance advises to assure maximum reimbursement from third party intermediaries.
- Confers with insurance representatives, Orange County Health Care Agency staff, and others on billing matters and answers questions that involve searching for and abstracting technical data and detailed explanation of regulations, policies, or procedures and refers only matters requiring policy decisions to supervisor.
- Conducts or directs the orientation of new staff members and the training of staff members; may provide orientation and training to billing personnel relative to billing systems and procedures.
- Assists in the development and implementation of new policies and procedures related to patient account billing; supervises the billing control filing system.
- Knowledge of: Principles and techniques of supervision and training; organization and operation of a hospital or health agency billing unit; third party insurance plans and State and Federal government regulations, policies and procedures regarding Medi-Cal, Medicare, Short-Doyle, and health program billing.
- Answers, screens, and directs calls on multi-line phone system in a courteous, respectful, and professional manner, takes messages and/or forwards telephone calls to appropriate person or location.
- Responds to visitors, guests, clients, representatives, and coworkers in a courteous, respectful, and professional manner.
- Ensures that the lobby area and reception desk are clean, organized, and free of clutter.
- Accepts mail and package deliveries and coordinates with addressees for pick up.
- Understands and follows directions, policies, and procedures and meets attendance and punctuality requirements.
- Effectively interacts and collaborates with clients and coworkers in a professional, respectful, courteous manner by maintaining appropriate personal and professional boundaries.
- Works collaboratively with Be Well Campus volunteers to ensure excellent experience.
- Assists management staff with other duties, as assigned.
**Qualifications**:
- Two (2) or more years of experience preparing and processing electronically-generated medical billing, preferably in a hospital, medical office, or public health setting.
- Two (2) or more years of experience in a managerial position, supervising others.
- Bachelor’s Degree in a relevant field is preferred.
- Knowledge or experience in the field of mental health and/or substance use treatment is preferred.
- Heavy MediCal billing experience is preferred.
- Thorough knowledge of Reasonable Collection Effort guidelines
- Knowledge of: Principles and techniques of supervision and training; organization and operation of a hospital or health agency billing unit; third party insurance plans and State and Federal government regulations, OC Health Care Agency billing; policies and procedures regarding Medi-Cal, Medicare, Short-Doyle, and health program billing.Must be organized, detail-oriented, and able to problem-solve in fast-paced environment.
- Experience reconciling complex client accounts using basic accounting principles
- Knowledge of medical terminology and/or Current Procedural Terminology (CPT), and International Classification of Diseases (ICD)
- Experience with Microsoft Excel and Word, and medical billing systems, including EHR (Electronic Health Records).
- Adept at analyzing complex client account balances for accuracy, identifying bad debt accounts through work queues and/or reports
- Must have exceptional customer service, and superior, appropriate written and oral communication skills.
- Ability to work under stress effectively and efficiently, with frequent interruptions, while maintaining professionalism and m
