billing services manager

Cox Automotive

<div>Cox Fleet is revolutionizing the industry with digital-first fleet solutions connecting fleets with maintenance experts, using data-driven technology via an automated marketplace of service providers &amp; proprietary fleet technology. Cox Fleet is Cox Automotive Mobility's digital marketplace; designed for fleets, operators and teams who need an on-demand service solution, data driven insights, and a team of fleet experts to support them so they can focus on their core business. 
 
The Manager, Billing will help lead and manage our billing operations. This role ill work closely with cross-functional teams, including IT and Business Process departments to design, implement, integrate, and support scalable billing solutions. The Manager, Billing is a proactive and strategic leader with a strong focus on operational efficiency, process optimization and a commitment to delivering excellence. 
 
PRIMARY DUTIES/KEY RESPONSIBILITES 
<ul><li>
Provides leadership and direction to supervisors and teams within the Billing department, ensuring alignment with organizational goals and service standards.</li><li>
Oversees the overall health and effectiveness of billing and/or payment processes, ensuring accuracy, timeliness, and compliance.</li><li>
Validates the integrity of process controls and ensures adherence to established protocols.</li><li>
Identifies, recommends, and drives the implementation of process enhancements, strategic initiatives, and system improvements across the end-to-end billing and payment lifecycle.</li><li>
Ensures that billing operations are designed to minimize customer impact and support a seamless client experience.</li><li>
Oversees the monitoring, tracking, and analysis of reports to identify trends and areas for improvement.</li><li>
Investigates process irregularities and escalates complex issues to senior leadership for resolution as appropriate.</li><li>
Coordinates and supports internal and external audits to ensure compliane with billing standards and company standards.</li><li>
Continuously evaluates operational performance and recommends actionable steps for ongoing process optimization.</li><li>
Represents the Billing function on cross-functional teams, contributing to the design and development of technical solutions and procedural enhancements.</li><li>
All other duties as assigned.</li><li>
undefined</li></ul> 
Required Experience &amp; Specialized Knowledge and skills 
 
<ul><li>Bachelor's Degree with at least 6 years of relevant experience; or</li></ul> 
<ul><li>Master's Degree with at least 4 years of relevant experience; or</li></ul> 
<ul><li>An equivalent combination of education and years of relevant experience.</li></ul> 
<ul><li>At least one year experience in a management or lead role.</li></ul> 
<ul><li>Experience in the automotive industry or fleet management a plus.</li></ul> 
<ul><li>Excellent communication (written and verbal) and interpersonal skills required</li></ul> 
<ul><li>Ability to work in a high performance, fast-paced team environment</li></ul> 
<ul><li>Relationship building &amp; networking</li></ul> 
USD 89,400.00 - 134,000.00 per year 
 
Compensation: 
 
Compensation includes a base salary in the range of $89,400.00 - $134,000.00. The base salary may vary within the anticipated base pay range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include an incentive program. 
 
Benefits: 
 
The Company offers eligible employees the flexibility to take as much vacation with pay as they deem consistent with their duties, the company's needs, and its obligations; seven paid holidays throughout the calendar year; and up to 160 hours of paid wellness annually for their own wellness or that of family members. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. 
 
Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. 
 
EOE, including disability/vets</div>

Manager, Billing

Healing Partners

<div>Revenue Cycle Manager &ndash; Billing
Classification: Exempt
Reports to: Director of Revenue Cycle
Date: April 2024 
Summary/Overview
Working closely with the Director of Revenue Cycle, the Revenue Cycle Manager &ndash; Billing is responsible for managing the Billing of accurate and timely claims. Develops and maintains the policies and procedures to effectively manage the billing and coding teams. 
Primary Duties and Responsibilities<ul><li>
Prepares, reviews and analyzes the effectiveness of the department using KPI&rsquo;s and reporting.</li><li>
Provides a goal-oriented work environment by establishing protocols and standards to ensure accurate and timely processes. Develops and plans goals and objectives for the department with the Director and Management Team.</li><li>
Coordinates and prioritizes assigned activities to achieve maximum productivity and assumes responsibility for professional growth and development.</li><li>
Reviews and evaluates trends. Collaborate and resolve issues with other departments; make recommendations to the Director to implement appropriate measures to decrease lost revenue.</li><li>
Work with Clinical Leadership on updating coding requirements and assisting in clinical education when needed.</li><li>
Supervises directly or indirectly, exempt, and nonexempt personnel engaged in the department. This includes interviewing, hiring, performance evaluation, training, time keeping, and disciplining all department personnel. Delegates authority as determined appropriate.</li><li>
Responsible for organizing and designing more efficient procedures for timely resolution of claim edits and procedure reviews.</li><li>
Identifying trending errors by providers and reporting to Director of Revenue Cycle and Clinical Leadership for training purposes.</li><li>
Participate in departmental and organization-wide meetings/workgroups. Conducts meetings with managerial staff and interacts closely with other departments to provide a smooth business flow to reflect the effectiveness and scope of all policies and procedures administered by the department.</li><li>
Resolve customer service issues promptly and with satisfaction to the patients involved. Show a positive and professional image when interacting with patients, management, staff, and others.</li></ul>
Education &amp; Experience<ul><li>
Bachelor's degree in business, Finance, or similar OR Three (3) years of Relevant Experience in the healthcare industry with knowledge of collections, billing, and/or cash posting.</li><li>
One (1) year of supervisor/management experience, preferably in a healthcare setting.</li><li>
Knowledge of the use of medical records, billing claim forms, and federal and state regulations concerning the use of medical records and medical billing.</li><li>
Experience in directing the daily activities of a cash posting team in a high volume, complex setting.</li></ul>
Qualifications<ul><li>
Strong analytical skills are necessary to analyze various accounting problems.</li><li>
Strong knowledge of CPT, ICD10 codes and modifiers.</li><li>
Proficient in MS Office suite of applications, billing systems, and business intelligence tools</li><li>
Ability to manage, evaluate, understand, and act on analysis of large datasets</li><li>
Excellent written and verbal communication skills are necessary to successfully perform all managerial responsibilities.</li><li>
Self-motivated and comfortable managing multiple tasks at the same time</li><li>
Demonstrates the ability to perform responsibilities in a fast-paced environment, requiring excellent organizational skills, sound judgment and critical decision making.</li><li>
Team player with positive attitude and effective communication skills</li><li>
Ability to work flexible hours when needed to deliver results</li></ul>
Physical Requirements
While performing the essential functions of this job, the following are required:<ul><li>
Talk, hear, and communicate with people over the telephone;</li><li>
Use hands and fingers to operate a computer and telephone;</li><li>
View computer screens for extended periods of time;</li><li>
Sit at a desk for extended periods of time; and</li><li>
Regular, predictable attendance.</li></ul> 
Work Location Requirements<ul><li>
The job duties and functions for this position are performed hybrid, based on work projects and management discretion. This position may require onsite work.</li></ul></div>

Revenue Cycle Manager-Billing

Vitreous Retina Macula Consultants of New York

<div><h2 class="jobSectionHeader">Working at VRMNY</h2>
Vitreous Retina Macula Consultants of New York (VRMNY) is one of the nation&rsquo;s leading retina practices, known for world‑class physicians, cutting‑edge treatments, and a commitment to exceptional patient care. With multiple locations across NYC, VRMNY combines academic‑level expertise with a collaborative, mission‑driven culture. Team members at VRMNY work alongside top retina specialists, contribute to meaningful patient outcomes, and operate within a dynamic environment that values innovation, accountability, and professional growth. Joining VRMNY means becoming part of a respected organization that sets the standard for retina care in New York and beyond.
The Billing Manager oversees the full revenue cycle operations for a high‑volume, multi‑location retina practice in New York City. This role is responsible for leading the billing and AR department, ensuring accurate and timely claims submission, optimizing collections, and maintaining compliance with payer and regulatory requirements. The ideal candidate has deep experience in ophthalmology/retina billing, strong knowledge of Medicare billing rules and reimbursement, advanced analytical and reporting skills, and the ability to synthesize complex data into actionable insights for leadership.<h3 class="jobSectionHeader">
Key Responsibilities</h3><ul><li>
Lead and manage the billing, AR, and collections teams across multiple practice locations.</li><li>
Oversee full revenue cycle operations including charge capture, coding accuracy, claims submission, payment posting, denials management, and appeals.</li><li>
Manage drug AR, including tracking high‑cost retina pharmaceuticals, reconciling buy‑and‑bill inventory, and ensuring accurate reimbursement.</li><li>
Oversee inventory processes related to retina injectables and surgical supplies, ensuring alignment between clinical usage, billing, and purchasing.</li><li>
Direct and maintain credentialing and re‑credentialing for all providers with commercial payers, Medicare, Medicaid, and managed care plans.</li><li>
Monitor AR aging, establish performance benchmarks, and implement corrective action plans to reduce outstanding balances.</li><li>
Develop and maintain dashboards, KPIs, and financial reports for leadership; provide clear data synthesis, forecasting, and projections to support operational and strategic decisions.</li><li>
Conduct root‑cause analysis on denials, underpayments, and payer trends; implement process improvements to maximize revenue.</li><li>
Ensure compliance with HIPAA, payer policies, Medicare billing guidelines, and retina‑specific coding requirements.</li><li>
Collaborate closely with clinical, administrative, and operational leadership to streamline workflows and support practice growth.</li><li>
Train, mentor, and evaluate billing staff; establish accountability and performance standards.</li></ul><h3 class="jobSectionHeader">
Qualifications</h3><ul><li>
5+ years of medical billing experience, preferably in ophthalmology or retina.</li><li>
Strong knowledge of Medicare billing, coverage policies, and reimbursement methodologies.</li><li>
Deep understanding of retina‑specific coding (e.g., injections, imaging, procedures) and buy‑and‑bill reimbursement.</li><li>
Proven experience managing multi‑site billing operations.</li><li>
Exceptional analytical skills with the ability to interpret data, build reports, and forecast trends.</li><li>
Proficiency in EMR/EHR and practice management systems; experience with reporting tools preferred.</li><li>
Strong leadership, communication, and problem‑solving abilities.</li><li>
Ability to thrive in a fast‑paced, high‑volume environment.</li></ul> 
Salary: $85,000&ndash;$95,000, commensurate with experience
buYlCX6Tki</div>

Billing Manager – Retina Practice (Multi‑Location, NYC)

Summation Financial Services

<div><h3 class="jobSectionHeader">Mobile Business Office Manager (On-Site, Travel Required)</h3>

Summation Financial Services 
Boston, MA (Greater Boston Area) 
Full-Time

<h3 class="jobSectionHeader">Position Overview</h3>

Summation Financial Services is hiring a Mobile Business Office Manager to support business office operations across skilled nursing facilities in the Boston and Greater Boston area.

This is a fully on-site, travel-based role requiring regular local travel between facilities. This position is not remote.

In this role, you will provide hands-on leadership, training, and operational support to ensure strong financial performance, accurate billing, and compliance across multiple locations.

<h3 class="jobSectionHeader">Key Responsibilities</h3>

Accounts Receivable &amp; Billing
<ul>
<li>Manage and oversee Medicare, Medicaid, and private pay billing</li>
<li>Monitor accounts receivable aging, collections, and cash flow</li>
<li>Identify and resolve billing discrepancies and denials</li>
<li>Report delinquent accounts and trends to leadership</li>
</ul>
Operational Support &amp; Coverage
<ul>
<li>Step in as needed to perform Business Office Manager or Billing Assistant duties</li>
<li>Provide coverage during staffing shortages or transitions</li>
<li>Ensure continuity of business office operations across facilities</li>
</ul>
Training &amp; Process Improvement
<ul>
<li>Train and support on-site staff in billing systems and best practices</li>
<li>Implement standardized processes to improve accuracy, compliance, and efficiency</li>
<li>Assist with system implementations and workflow improvements</li>
</ul>
Compliance &amp; Reporting
<ul>
<li>Ensure adherence to state, federal, and payer regulations</li>
<li>Maintain accurate documentation and audit readiness</li>
</ul><h3 class="jobSectionHeader">Qualifications</h3>
<ul><li>Minimum 2+ years of experience in healthcare billing, accounts receivable, or business office operations</li>
<li>Experience in skilled nursing facilities (SNF) or long-term care strongly preferred</li>
<li>Strong knowledge of Medicare, Medicaid, and insurance billing processes</li>
<li>Proven ability to improve AR performance and resolve complex billing issues</li>
<li>Excellent organizational, communication, and problem-solving skills</li>
<li>Ability to travel locally between facilities on a regular basis</li>
</ul><h3 class="jobSectionHeader">Compensation &amp; Benefits</h3>

We offer a competitive compensation package including:
<ul>
<li>Medical, Dental, and Vision Insurance</li>
<li>Prescription Coverage &amp; Telemedicine</li>
<li>Health Savings Account (HSA) &amp; Flexible Spending Account (FSA)</li>
<li>Company-Paid Life Insurance</li>
<li>401(k) Retirement Plan</li>
<li>Paid Time Off (PTO)</li>
<li>Employee Assistance Program (EAP)</li>
</ul><h3 class="jobSectionHeader">Why Join Summation Financial Services?</h3>
<ul><li>Work in a high-impact role supporting multiple healthcare facilities</li>
<li>Gain exposure to diverse operational environments</li>
<li>Be a key contributor in improving financial performance and compliance</li>
<li>Join a team focused on support, structure, and results</li>
</ul><h3 class="jobSectionHeader">Apply Today</h3>

If you have a background in healthcare billing and enjoy a hands-on, fast-paced role with travel, we encourage you to apply. 

<div>
SFSMBOM</div></div>

Mobile Business Office Manager (On-Site, Travel Required)

Revolut

<div>About Revolut
People deserve more from their money. More visibility, more control, and more freedom. Since 2015, Revolut has been on a mission to deliver just that. Our powerhouse of products &mdash; including spending, saving, investing, exchanging, travelling, and more &mdash; help our 75+ million customers get more from their money every day.
As we continue our lightning-fast growth,&zwnj; 2 things are essential to our success: our people and our culture. In recognition of our outstanding employee experience, we've been certified as a Great Place to Work&trade;. So far, we have 13,000+ people working around the world, from our offices and remotely, to help us achieve our mission. And we're looking for more brilliant people. People who love building great products, redefining success, and turning the complexity of a chaotic world into the simplicity of a beautiful solution.
About the role
At Revolut, Operations means problem-solving at scale. Our team tackles the company&rsquo;s toughest challenges with speed, precision, and creativity. They design systems that unlock efficiency and power global growth.
We&rsquo;re looking for a Payments Implementation Manager to ensure efficient and secure local payment operations. You'll be maintaining compliance and managing relationships with key payment systems across the UAE.
Up to shape what's next in finance? Let&rsquo;s get in touch.
What you'll be doing<ul><li>
Establishing and maintaining excellent working relationships with local payments systems, acting as the point of contact on behalf of Revolut</li><li>
Ensuring adherence to relevant regulations, guidelines, and procedures</li><li>
Conducting payment operations and overseeing end-to-end processes, including transaction initiation, verification, reconciliation, and settlement</li><li>
Collaborating with internal IT teams to address any technical issues related to payment systems</li><li>
Generating regular reports on payment activities, volumes, and performance metrics to support decision-making and remain in compliance with regulatory requirements</li><li>
Monitoring and mitigating payment-related risks, such as fraud, errors, and operational disruptions, by suggesting appropriate control measures and conducting risk assessments</li><li>
Engaging in industry forums and working groups</li><li>
Staying updated with the latest trends, regulations, and innovations in the payment industry, continually enhancing professional knowledge and skills</li></ul>
What you'll need<ul><li>
5+ years of experience in local payment schemes</li><li>
User certifications/trainings in local payment system operations</li><li>
In-depth knowledge of relevant payments legislation</li><li>
Fluency in English</li><li>
Exceptional communication and writing skills</li></ul>
Building a global financial super app isn&rsquo;t enough. Our Revoluters are a priority, and that&rsquo;s why in 2021 we launched our inaugural D&amp;I Framework, designed to help us thrive and grow everyday. We're not just doing this because it's the right thing to do. We&rsquo;re doing it because we know that seeking out diverse talent and creating an inclusive workplace is the way to create exceptional, innovative products and services for our customers. That&rsquo;s why we encourage applications from people with diverse backgrounds and experiences to join this multicultural, hard-working team.
Important notice for candidates:
Job scams are on the rise. Please keep these guidelines in mind when applying for any open roles.<ul><li>Only apply through official Revolut channels. We don&rsquo;t use any third-party services or platforms for our recruitment.</li><li>Always double-check the emails you receive. Make sure all communications are being done through official Revolut emails, with an @revolut.com domain.</li></ul>
We won't ask for payment or personal financial information during the hiring process. If anyone does ask you for this, it&rsquo;s a scam. Report it immediately.
By submitting this application, I confirm that all the information given by me in this application for employment and any additional documents attached hereto are true to the best of my knowledge and that I have not wilfully suppressed any material fact. I confirm I have disclosed if applicable any previous employment with Revolut. I accept that if any of the information given by me in this application is in any way false or incorrect, my application may be rejected, any offer of employment may be withdrawn or my employment with Revolut may be terminated summarily or I may be dismissed. By submitting this application, I agree that my personal data will be processed in accordance with Revolut's Candidate Privacy Notice</div>

Payments Implementation Manager

DeKalb Community Service Board

About Claratel Behavioral Health
 Claratel Behavioral Health is an innovative, community-based behavioral health and developmental disabilities services organization offering a full range of mental health, developmental disabilities, and substance use disorder services to underserved individuals. As a public, not-for-profit organization, Claratel Behavioral Health operates in more than 20 locations in DeKalb County, Georgia, with a diverse workforce of more than 400 direct-care and support staff.
 If you are passionate about driving change in behavioral health and developmental services and are eager to work in an environment that values innovation and inclusivity, Claratel Behavioral Health is the place for you. Here, your work is impactful, your growth is prioritized, and your well-being is supported. Together, we can forge pathways to a healthier future for all.
 
Billing Manager
 Location: Claratel Winn Way- 445 Winn Way, Decatur, GA 30030
 Hours: Monday – Friday 8:00am- 5:00pm (Hybrid)
 Claratel Behavioral Health is seeking a dedicated and experienced Billing Manager to oversees the day-to-day operations of the billing department ensuring accurate and timely claims submission, payment posting, and accounts receivable management. This position leads a team of billing specialists, denial management specialists, eligibility verification specialists, and credentialing specialists and works cross-functionally with the clinical and utilization management teams to optimize revenue, minimize denials, and ensure compliance with payer guidelines and regulatory standards.
 
Key Responsibilities: 
<ul>
<li>Manage the billing team, including hiring, training, supervising, and evaluating staff performance</li>
<li>Ensure accurate and timely submission of behavioral health claims to Medicaid, Medicare, and commercial payers</li>
<li>Oversee payment posting, charge entry, refunds, and accounts receivable follow-up processes</li>
<li>Monitor billing performance metrics and aging reports to ensure timely collections and minimize outstanding balances</li>
<li>Analyze claim denials, identify trends, and implement corrective actions in collaboration with denial management and clinical teams</li>
<li>Coordinate with clinical and utilization management teams to prevent billing disruptions</li>
<li>Ensure compliance with all applicable billing regulations, coding guidelines, and HIPAA requirements</li>
<li>Maintain and update billing policies and procedures to reflect payer updates and regulatory changes</li>
<li>Prepare regular reports for leadership on collections, AR trends, denials, and billing KPIs</li>
<li>Lead billing-related audits and support financial reporting requirements</li>
<li>Serve as the billing subject matter expert for new program implementations and payer contracts</li>
</ul>
Skills and Competencies: 
<ul>
<li>In-depth knowledge of behavioral health billing, including Medicaid, Medicare, and managed care payers</li>
<li>Proficiency in EHR and billing systems (Preferably Avatar)</li>
<li>Strong understanding of CPT, HCPCS, ICD-10 coding, and behavioral health modifiers</li>
<li>Excellent leadership, team management, and communication skills</li>
<li>Ability to analyze data, generate reports, and drive performance improvements</li>
<li>Strong organizational and time management skills with attention to detail</li>
<li>Ability to manage competing priorities and deadlines in a fast-paced environment</li>
<li>Knowledge of compliance standards and HIPAA requirements</li>
</ul>
Preferred Experience: 
<ul>
<li>3–5 years of billing experience in a healthcare setting, with at least 2 years in behavioral health</li>
<li>2+ years of experience in a supervisory or management role</li>
<li>Certification such as Certified Professional Biller (CPB), Certified Revenue Cycle Professional (CRCP), or related credential preferred</li>
</ul>
Pre-employment drug screening and successful completion of a criminal history background check is required.
 Claratel Behavioral Health participates in E-Verify (Company ID: 226305)
 
Claratel Behavioral Health is an Equal Opportunity Employer. Candidates who may require an accommodation under the Americans with Disabilities Act or similar law to perform the essential functions of this job are encouraged to contact Human Resources at hrhelp@claratel.org.

Revenue Cycle Manager - 130801

Kaweah Health

<div>Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.
It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do &mdash; in the health of our patients, our loved ones, and our community.
Benefits Eligible
Full-Time Benefit Eligible
Work Shift
Day - 8 Hour or less Shift (United States of America)
Department
8530 Patient Financial Services
Maintains complete and full knowledge of payer(s) assigned to ensure accurate billing and collection of the claims. Validates that the Kaweah Health is being reimbursed by the payer in accordance with government or contract terms.
QUALIFICATIONS
Education
Preferred: High school diploma or equivalent
Experience
Required: Prior Patient Accounting or admissions experience. Comparable medical billing education may be considered.
JOB RESPONSIBILITIES
Essential
Maintains complete and full knowledge of payer(s) assigned to ensure compliance of specific guidelines and rules, as well as ensuring the Kaweah Health is being reimbursed by the payer in accordance with governmental or contract terms. Is a resource to Finance division management regarding the assigned payer.
Brings any reimbursement or compliance concerns to the attention of the Patient Accounting Manager.
Utilizes computer systems and/or billing reports to review all patient registrations or admissions for demographic information, appropriate financial class, insurance company and plan, and charges. 100% accuracy of this information is required to ensure proper recording of revenue, necessary authorizations are obtained, payer classification, correct billing of patient account, and other statistical indicators. Brings any unresolved issues to the attention of their manager.
Audits unbilled reports for potential holdups of patient accounts. Works closely with Medical Records on coding issues, Insurance Verification Clerk on insurance issues and other departments as necessary.
Completes billing process. Ensures all charges are accurate and appropriate. Payer guidelines will be followed during the billing process. After billing has been completed, uses appropriate charge description master (CDM) number to identify the payer and when the account was billed. Works closely with departments on unresolved issues.
Reviews and researches patient account credits and refunds as appropriate to patient and/or payer. For governmental payers, has the credit retracted.
Receives all correspondence and inquiries related to patient accounts and payer contract for which they are responsible. Answers mail and take appropriate action within specified timeframe.
Bills any secondary payers, change financial classes accordingly and sends appropriate collection system letter to patient for co-pays and deductibles owed, denied services, amounts applied to deductible, etc. Uses correct CDM code to identify what secondary payer was billed and when.
Reviews and works aging reports to identify unpaid patient accounts. Follows up with payers for timely reimbursement.
Works to ensure that days in accounts receivable goals are met maintained and/or lowered. Maintains job productivity and quality standards on a consistent basis as established by division management.
Answers phones as a back up to other departmental staff. Takes messages or routes calls as appropriate. As back up, assists customers at the service counter.
Conforms with patient confidentiality standards.
Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area.
Performs other duties as assigned.
Addendum (essential for specific dept)
Insurance or managed care payer:
Has complete knowledge of assigned insurance payer, knows contract terms, requirements and payment practices.
Receives prior day's explanation of benefits or remittance advices for assigned payer(s). Reviews to ensure that appropriate contractual adjustments have been taken by payer. Works closely with payer to resolve issues and brings continued problems to the attention of their manager.
Monitors patient accounts for secondary payer reimbursement.
Medicare payer:
Gets electronic remittance advice (R/A) ready for the Accounts Receivable Clerks. Distributes Medicare mail.
Reviews DRG worksheet for accuracy of reimbursement. Reviews all denied changes for appropriateness.
Reviews the Pending Billing List report and deletes non-covered services. Checks for overlapping claims through accounts receivable inquiry (ARI).
Reviews and processes recurring accounts according to procedure.
If responsible for professional billing, processes these bills according to procedure.
Reviews and follow up on the DDE system.
Medi-Cal payer:
Maintains full and complete knowledge of the regulations governing the Medi-Cal payer.
Reviews the Pending Billing List report and/or the Final Accounts and Cycle Billed report. Follow up is completed according to procedure.
Reviews and processes R/A's following procedure.
Reviews MEDTRIEVE data to identify problems in billing. Reviews statistical data with their Manager to maximize reimbursement
Reviews Medi-Cal TAR Dashboard weekly for any follow up on approved or denied TARs.
Self-pay accounts:
Responsible for the administration of the Computer Collection letter service interface (CCI) process.
Prepares and completes the bad debt write-off and assignment to the collection agency.
Acts as a liaison to the collection agency and works with patients regarding hospital accounts assigned.
Responsible to identify patient accounts that may qualify for charity care. Works with patients who inquire about charity program.
Monitors patient accounts pending the Medi-Cal disability process and/or TCMS program.
Responsible for the estate lien filing in the case of deceased patients to assure that the Kaweah Health receives payment on accounts.
Lead also responsible for:
May be responsible for educating individuals in the Patient Accounting Department on new processes and/or payment regulations.
May be assigned to develop training curriculum on new processes.
Provides department staff with information regarding updates or changes.
May serve as a Subject Matter Expert (SME) for systems issues and claim payment issues.
Identifies, investigates, and appropriately communicates account errors in order to prevent further errors.
Proactively and critically analyzes departmental processes and products, makes continuous improvements.
Keeps the Director of Patient Financial Services informed of any potential issues or areas of concern on an ongoing basis.
Pay Range
$23.37 -$35.05
If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong.</div>

Patient Account Specialist

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