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Vista Del Mar · 2 days ago

Billing Manager

3200 Motor Ave. Los Angeles, CA 90032

Full-time

Onsite

Entry, Mid Level

$70K/yr - $80K/yr

1+ years exp

Vista Del Mar Child & Family Services is dedicated to providing exceptional programs and services for children and families in LA County. The Billing Manager will oversee contract and client claims submission, manage billing processes, and supervise staff to ensure compliance and accuracy in billing practices.

FamilyHealth CareNon ProfitPersonal HealthWellness

Responsibilities

Oversee contract and client claims submission, funding eligibility and verification, provide supervision and task coordination to Quality, Standards and Compliance Department functions

Manages projects, data collection and running data repo

Manage monthly Third-Party Billing. To include Eligibility verification of insurance benefits and California State Victims of Crime (VOC) Communicate benefit information and insurance requirements accurately to clinicians and clients. Create and maintain client’s insurance record containing demographic information and summary of services related to the client. Monthly submit claims to insurance or State VOC, verify receipt and processing. Review EOBs for accuracy of benefits paid, denied, or unpaid. Enter reconciled claims into the DMH Integrated System (IS). Performs various collection actions including contacting parents/guardians by phone, correcting and resubmitting claims to third party payers. Maintain accounting of claims submitted, received and outstanding

Oversee client funding eligibilities and verification documentation for DMH contract, including State Medi-Cal eligibility verification batch files and TIER eligibility and funding screens for OPS clients at admission and monthly thereafter

Run, review, and disperse TIER Unit of Service billing reports weekly of all VDM programs for data entry into the DMH IS

Run weekly/monthly, or as needed DMH IS UOS report Reports to include, but not limited to, Denied Claims, Unclaimed, and Claim Detail Export. Problem-solve denied claim errors, replace claims, and collaborate with DMH Revenue Management on unresolved issues, when needed. Provide corrective action for monthly Void Report. Disperse Unclaimed Report to data entry staff monthly

Run weekly/monthly, or as needed identified client status IS reports, i.e. 30/60/90 Day Report, UMDAP, and disperse to designated Quality Assurance staff for follow-up

Run EFT, raw data claims reports as needed

Manage quarterly OPS program progress note/billing review Review and assess OPS clinician feedback and cross-reference against original service log. Make appropriate corrections in the DMH IS. Maintain record of changes made

Manage the electronic submission of all DMH contract eligible staff’s Rendering Provider and PRM online information to add new staff, update license/registration and valid taxonomy information, add NPI and provider number to staff members, and submit staff termination documentation to DMH. Maintain active staff provider binders with staff personnel sheets and current license, NPI and taxonomy. Run IS280 report monthly to obtain list of rendering provider information and insure TIER is updated with NPI and rendering provider number. Follow-up with Human Resource regarding expired or missing licenses

Manages the Outcomes submission for Evidenced Based Practice and Field Capable Clinical Services cases into the DMH OMA web site. Is responsible for training other assigned staff in the protocol to ensure submission is accurate and timely

Attends DMH meetings and trainings that pertain to her job responsibilities, i.e. data reporting, outcomes reporting, etc., and informs staff of updates and changes, and trains staff as needed

Supervises billing staff, ensuring that billing standards, practices and protocols are consistently met, regularly meets with supervisees to review assignments and any billing issues that may arise. Provides direction to assist with problem solving and when corrective action is needed

Qualification

Medical Billing CertificationCPT-4 CodingICD-9 CodingMicrosoft ExcelMicrosoft WordMultitaskingDisturbed ChildrenDetail OrientedOral CommunicationWritten CommunicationTeam Collaboration