Medical Billing Manager

Job Locations US-CA-Anaheim
Posted Date 2 months ago(7/15/2021 12:23 PM)
Job ID
2021-2256
# of Openings
1
Category
Finance/Accounting/Purchasing

Overview

Planned Parenthood of Orange and San Bernardino Counties has a full-time opportunity for a Medical Billing Manager in Anaheim, CA responsible for managing unbilled A/R by minimizing the amount of time necessary to affect a clean claim so that cash collections are maximized with minimal denials. Manage the daily billing operations including charge entry, charge review, claim correction, claim transmission, clearinghouse and payer reports related to inbound and outbound claim files.

 

At PPOSBC, we understand the importance of a well-rounded benefits program and are dedicated to providing you with unique benefits that meet the needs of you and your family. We are proud to offer a range of plans that help protect you in the case of illness or injury including:

  • A competitive benefits package including medical, dental, and vision coverage for you and eligible dependents, life insurance, and long term disability. 
  • Benefits coverage starts after one full month of employment!
  • Generous vacation, sick, and holiday benefits!
  • Generous 401(k) matching contributions and more!
  • To view our detailed benefits guide, please visit our career site at www.pposbccareers.org

Responsibilities

Essential Functions:  Essential functions encompass the required tasks, duties and responsibilities performed as part of the job and the reason the job exists.

  • Manages front end denials to ensure timely corrections are made at the time of billing using EMR and Clearinghouse edits, automation and effective front-end communication.
  • Responsible for electronic and paper claim submission.
  • Assigns employees responsibility for verifying the integrity of client information entered into the system is complete and accurate.
  • The Medical Billing Manager is knowledgeable in electronic medical records, and practice management functions, capabilities.
  • Coordinates service tickets, and system changes with Information Technology and the practice management vendor, while communicating updates to management and with billing team.
  • Establishes lines of communication with center managers to ensure accuracy and confidentiality of patient accounting records. Coordinates with personnel in clinics and administration to exchange information and update internal controls.
  • Ensures correct insurances are attached and updated according to eligibility responses and DOFR assignment.
  • Completes month-end reporting of account receivable reports to ascertain status of collections and balances outstanding and to evaluate effectiveness of current collection policies and procedures. Reports findings to Director of Revenue Cycle weekly and as requested.
  • Responsible for reading and updating State and Federal procedures and codes necessary, including CPT4 and ICD9 diagnosis codes.
  • Compiles and analyzes statistical data on patient accounts for review by senior management and clinic managers to assist in monitoring key productivity indicators.
  • Coordinates with Systems Administrator for updating of patient accounting systems.
  • Responsible for updating of patient charges, and billing forms.
  • Monitors biller activities to ensure maximum productivity and prepare periodic and annual evaluation of patient accounting staff through documentation of productivity, accomplishments and error rates.
  • Performs month-end closing for patient revenue accounts.
  • Work closely with IT and eCW to determine if their billing software will meet all of our needs. Report to senior management with recommendation. 
  • Other duties as assigned by Director of Revenue Cycle.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Minimum Education: 

  • Bachelor's Degree in healthcare or related field or equivalent relevant experience required.

Minimum Work Experience:

  • Experience in Revenue Cycle, Medical Billing, Payment, Collections is a must.
  • Minimum of Five years of outpatient/inpatient medical billing experience or equivalent combination of education and experience.
  • Medi-Cal, Medi-Cal Managed Care and Medi-Cal Programs billing experience required.
  • Electronic billing and Electronic Medical Record ‘EMR’ experience is a must.
  • Practice Management functionality, set-up, and training preferred.

Supervisory Experience: (5 years minimum supervisory experience)

  • Carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws.
  • Responsibilities include interviewing, hiring and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
  • The Medical Billing Manager produces productivity reports to monitor, measure, and evaluate effectiveness of billing team and billing activities.
  • Is knowledgeable in HIPAA, HIPAA 5010 transactions, EMR/ePM, Payer guidelines and regulations, Medical Billing and Coding, and personnel management.

Other Experience:

  • Strong commitment to quality healthcare and excellent customer service.
  • Excellent written and verbal communication skills.
  • Ability to demonstrate mature judgment, initiative and critical thinking.
  • Knowledge of CPT4 and ICD-9 and awareness of ICD-10 coding a must.
  • Accuracy and attention to detail essential.
  • Knowledge of Medi-Cal and Medi-Cal programs, Medi-Cal Managed Care payers, Commercial PPO and HMO payers, Ancillary Contracting Agreements, and Letters of Agreements.
  • Ability to relate to diverse communities.
  • Maintain professional demeanor at all times.
  • Availability to work flexible hours including weekend.
  • Requires valid CA driver’s license and a reliable means of transportation and current auto insurance in compliance with the minimum requirements of the California Vehicle Code standards of bodily injury and property damage.

All employees are required to be fully vaccinated for COVID-19 unless a reasonable accommodation is approved for a medical/disability or religious exemption.

Planned Parenthood/Orange and San Bernardino Counties is an equal opportunity employer. Applicants will receive consideration for employment without regard to race, color, ancestry, national origin, religion, creed, equal pay, age, disability, sex, gender, sexual orientation, gender identity, gender expression, medical condition, genetic information, marital status, military, veteran status or any other federal or state protected class. We are committed to building and maintaining an inclusive workplace that values diversity, equity, and inclusion.

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