Billing Manager

GET TO KNOW US:

For over 100 years, Vista Del Mar Child & Family Services (VDM) has taken great pride in providing exceptional programs and services for children and families throughout LA County. VDM envisions a community where all children and families are equipped and prepared to live productive, fulfilling lives. We serve the most vulnerable in Los Angeles, many of whom have faced multi-generational inequities. Vista Del Mar is guided by core values of empowerment, equity, and excellence.

CULTURE:

Folks who are Black, Indigenous, people of color, LGBTQ+, of a marginalized gender, disabled, parents, are/have been system-impacted, are immigrants, and anyone who has experienced systemic oppression, and/or gender-based violence are encouraged to apply.

MISSION:

Vista Del Mar provides a trauma-responsive continuum of services to empower children, youth, and families in Southern California to lead fulfilling lives.

POSITION OVERVIEW

The primary responsibility of the Quality, Standards and Compliance Billing Manager is to Oversee contract and client claims submission, funding   eligibility and verification, provide supervision and task coordination to Quality, Standards and Compliance Department  functions.

Essential Job Duties  

1. Manages projects, data collection and running data repo.

2. 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.

3. 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.

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

5. 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.

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

7. Run EFT, raw data claims reports as ne

8. 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.

9. 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 numb Follow-up with Human Resource regarding expired or missing licenses.

10. 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.

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

12. Supervises billing staff, ensuring that billing standards, practices and protocols are consistently me meets regularly 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.

WHAT YOU BRING TO VDM?

• Certification of Medical Billing / Health Claims Examiner or one year experience with medical insurance billing.  Must be familiar with medical terminology, CPT-4 and ICD-9 coding.


• Detail oriented and organized with strong ability to multitask


• Work cooperatively with others


• Outstanding oral and written communication skills


• Strong knowledge of Microsoft Office Excel and Microsoft Word.


• Experience working with disturbed children

SALARY: $70,350 - $80,000

What Can We Offer You for All Your Hard Work?

• Full benefits offered (Medical, Dental, Vision)


• FSA/Dependent Care and Supplemental benefits through The Standard


• 403(b) – 3% Employer contribution based off annual salary


• 4 Mental Health Days


• Up to 12 Paid Holidays


• Up to 25% for Cell Phone Discounts with 3 Major Carriers (AT&T, Verizon, Sprint)

Vista Del Mar’s Credentials:

Our nationally recognized clinical programs have been awarded a Gold Seal by the Joint Commission, the highest level of accreditation possible. In addition, our educational facilities are fully accredited through the Western Association of Schools and Colleges (WASC), and our graduate degree program is recognized worldwide for its high quality of instructions.

Equal Employment Statement

Vista Del Mar is committed to the full inclusion of all qualified individuals. Therefore, all qualified applicants will be considered for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Vista Del Mar will ensure that persons with disabilities are provided reasonable accommodations as part of this commitment.