Job Description
Medical Billing Manager Location Visalia, CA : One current vacancy with the Tulare County Health & Human Services Agency (HHSA), located in Visalia. This recruitment will establish an employment list to fill current and future vacancies in HHSA. The anticipated life of the employment list is six months. If interested in employment for this for current or future vacancies, please submit a completed application for consideration.
Typical Duties Develop, monitor and control revenue cycle management related to medical billing claims for healthcare practice and or health plan; oversee and manage the medical billing process, ensuring accuracy and efficiency; supervise and lead the billing team to optimize revenue cycle management; ensure accurate understanding of medical terminology, CPT codes, ICD-10 codes, and the use of billing modifiers; ensure timely and accurate submission of claims to Medi-Cal, Medicare, and commercial insurance companies through electronic and paper claims; ensure compliance with State and Federal healthcare regulations, billing guidelines, and credentialing requirements; ensure coordination of benefits including collection of required documentation, identifying opportunities to enhance billing processes and reduce denials; implement processes and procedures for timely verification of patient benefits and identifying responsible parties to bill for reimbursement; develop denial workflow and follow up; perform analysis of patient and insurance financial reports to identify trends and address issues; develop training material for clinic sites; provide for unit instruction and training on Medi-Cal, Medicare, third party insurance and claims processing; interpret, implement and explain Medi-Cal, Medicare and third party insurance regulation changes related to medical billing; administer the electronic claims processing system, analyze its functions, and make recommendations for system improvements; direct claims processing procedures and workflow to ensure efficiency of operations and compliance with standards and current regulations; supervise, train and evaluate the work of staff; prepare, analyze, review and provide management with reports related to medical billing activities; provide management with technical assistance and expertise in medical billing. Oversee all aspects of medical billing activities. Employment Standards MINIMUM QUALIFICATIONS Minimum qualifications are used as a guide for establishing the education, training, experience, special skills and/or license which are required and equivalent to the following. Education: Equivalent to graduation from an accredited four-year college or university with a bachelor's degree in accounting, business or public administration. Experience: Three (3) years of increasingly responsible experience in supervising all aspects of medical billing. Directly related experience may be substituted for the educational requirement on a year-for-year basis. Knowledge of: Principles and practices of supervision, management and employee development; revenue cycle management; Medi-Cal, Medicare, and private insurance regulations and billing practices; medical terminology, CPT codes, ICD-10 codes, and the use of billing modifiers; laws and regulations governing collection procedures; collection techniques, laws and practices; electronic medical billing systems and processes; claim processing, claim management, denial management, and remittance processing and follow up; research methods to compile and analyze healthcare billing information to formulate alternatives and recommendations; and accounting principles and practices in healthcare. Skill/Ability to: Direct, oversee and administer a medical billing unit; assign, coordinate and direct work activities of staff; supervise, evaluate, discipline and train staff; analyze data and reports and note trends or continued problems; assess overall effectiveness of business processes and design improvements and controls for medical billing operations; develop and implement policies and procedures relating to medical billing activities. Read, interpret and explain laws and regulations related to billing and collections; gather, assemble, analyze and evaluate facts, draw logical conclusions and make appropriate recommendations; coordinate billing system for maximum reimbursement; prepare statistical reports; prepare clear, concise reports using correct grammar, punctuation and spelling; establish cooperative working relationships with coworkers, organizations and the general public; operate standard office machines including a computer; initiate and coordinate changes to software to enhance performance. License or Certificate: Possession of, or ability to obtain, a valid California driver's license. DESIRABLE QUALIFICATIONS Knowledge of: Managed health care systems and claims system software to produce acceptable claims and statements per program regulations Additional Information Conditions of Employment:
- Possession of, or ability to obtain, an appropriate, valid California driver's license.
- Candidates selected will be required to pass a pre-employment drug and alcohol screening. Additionally, a background investigation may also be conducted, which may include a re-investigation every 10 years for some positions.
- An Employment Eligibility Verification using E-Verify may be required on the first day of employment for some positions.
- Some job classes may also require a physical exam.
College Cost Reduction Access Act : This may be a qualifying position for student loan forgiveness through the College Cost Reduction and Access Act (CCRAA). Only student loan payments made after October 1, 2007 and in a qualified repayment plan are eligible. For more information you are encouraged to speak with your student loan service or visit:
EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER
Bargaining Unit 19 The information listed is a general summary of benefits. These provisions do not constitute an expressed or implied contract and are subject to change. Benefit Amount: An annual benefit amount is provided and may be applied towards health insurance premiums (medical, dental, vision, life and long-term disability). This benefit is pro-rated and paid on a pay period basis (24 pay periods). Health Insurance: A choice of PPO and HMO medical plans which include PPO and HMO dental plans and include dental and vision coverage. Dependent coverage is available. Providers include Anthem Blue Cross, Kaiser Permanente, Delta Dental, and Vision Services Plan (VSP) . Retirement : The retirement plan is a defined benefit plan administered pursuant to the 1937 Act County Employees Retirement Act and integrated with Social Security. In addition to ordinary retirement benefits, the plan provides disability and death benefits. Retirement contributions are made by both the County and the employee. The County has reciprocity with the State of California, contracting PERS agencies, and all County 1937 Act Retirement Systems. Paid Holiday Leave : 12 set days and 1 personal holiday. Vacation Accrual : 2 weeks per year (0-3 years of service) 3 weeks per year (3-7 years of service) 4 weeks per year (7-11 years of service) 5 weeks per year (11+ years of service) Limit of 300 hours. FLSA exempt employees accrue an additional 5 days of vacation per year. Sick Leave Accrual : 12 days per year with unlimited accumulation, 48 hours of which may be used toward family sick leave. Group Term Life Insurance and AD&D: $10,000; Provided by Standard Insurance Company . Long Term Disability Insurance: A Long Term Disability plan is provided. This provides financial protection for you by paying a portion of your income while you are disabled. Employees are covered by State Disability Insurance. The premium is paid by the employee. Deferred Compensation : A voluntary deferred compensation plan is available. To view more detailed descriptions of Tulare County's benefits, please view the Benefits section of our Web site at The Provisions Of This Bulletin Do Not Constitute An Expressed Or Implied Contract And Are Subject To Change.
Job Tags
Holiday work, Full time, Contract work, Second job,