JOB SUMMARY
The Billing Systems Manager will oversee billing functions at all programs for unit/service billing entry and reconciliation. The Billing Systems Manager will work with MHS Billers to ensure timely submission into all funder billing systems and work in resolving any outstanding denied or open claims.
RESPONSIBILITIES
Reasonable accommodation may be made for individuals with disabilities to perform essential job functions.
• Oversee the billing operations of service coding, charge entry, claims submissions, payment postings, accounts receivable follow-up, collections, and reimbursement management.
• Audits current procedures to monitor and improve efficiency of billing and collections operations.
• Ensures that billing activities are conduced consistently with MHS protocol, Federal, State and local regulations as well as payor guidelines and requirements.
• Analyze trends impacting charges, coding, collection, and accounts receivable and take appropriate action to revise policies and procedures.
• Provides training to new and existing billing staff on applicable operating policies, systems and procedures, standards, and techniques.
• Ensures all MHS Billers enter service claims daily.
• Reviews daily billing receipts to monthly system reports.
• Assist with MHS Billers with charge correction/denials.
• Check billing logs for completion/errors. Coordinate billing reconciliation process with the MHS Billers.
• Generates data reports required monthly by MHS' Accounting Department and the Program Manager to ensure reimbursement by the Insurance for services rendered.
• Collaborates with the programs to monitor billing procedures and conduct utilization review.
• Attend Fiscal meetings as assigned by supervisor and communicate with fiscal staff regarding billing units and productivity.
• Performs word processing, spread sheet operations and database operations using an MS Windows compatible computer format and MS Office software.
QUALIFICATIONS
• Experience with Medi-Cal, Short/Doyle or ODS-DMC Medi-Cal billing.
• Advanced knowledge of county funder service claim entry systems. One year experience in County Behavioral Health billing systems and policies.
• One year experience in management.
• Administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.
• Experience with CPT and ICD Coding.
• Typing at 50 wpm. Complete basic computer skills using MS Windows operating system, including file back-up and problem troubleshooting. Word processing skills utilizing MS Word.
• Resourcefulness, initiative and the ability to work with minimal direction and supervision.
PHYSICAL REQUIREMENTS
These physical demands represent what must be met to successfully perform the essential functions of this position. As mentioned above, reasonable accommodation may be made for qualified disabilities.
☒ Seeing ☒ Hearing ☒ Speaking
☒ Stooping/Bending ☒ Working in cramped spaces ☒ Moving around facility
☒ Moving between offices/clients ☒ Driving • Climbing
☒ Lifting/carrying heavy items ☒ Pushing/pulling/dragging items ☒ Standing for long periods
• Working outside/underground ☒ Using hands/fingers ☒ Sitting for long periods
I can perform the above functions:
• Without accommodation • With accommodation. If so, please specify:
OTHER DUTIES
This job description isn't a comprehensive list of activities, duties or responsibilities required for this job. Duties, responsibilities and activities may change at any time with or without notice.
Employee signature constitutes an understanding of the job requirements, essential functions, and duties.
