Job Abstract

This position is partially remote, and you have the option to elect into a 9/80 flex work schedule. The pay range for this position is between $99,850 - $110,950 annually.

About Didi Hirsch

Didi Hirsch Mental Health Services has been a national leader in whole-person mental health, crisis care, and substance use services since 1942 and is home to the nation’s first Suicide Prevention Center. We are a nonprofit organization providing care to nearly 200,000 people annually across our programs. Didi Hirsch has deep roots in community-based mental health and a commitment to providing culturally responsive services that are just and equitable.

As an organization, we value equity, diversity, and inclusion. More than 1,000 dedicated employees and volunteers make Didi Hirsch’s work possible. We intentionally recruit and retain a workforce that is reflective of the communities we serve and strive to cultivate a sense of belonging for them. We embrace employees and candidates from all backgrounds who want to help make this vision a reality.

Summary

Manage the Business Office staff to ensure accurate and timely submission of claims in accordance with agency, county, state, and federal standards. Responsible for the documentation of Business Office workflows and assist in the development of procedures.

Primary Duties

• Performs routine supervisory duties including interviewing applicants for employment; sets, assigns and reviews progress of assignments; participates in performance appraisals; and promotes growth in staff by providing learning/cross-training opportunities within the department.
• Evaluates and monitors business office support staff duties and performance regarding the Business Office and Task needs in respective functional areas.
• Responsible for the accurate and timely entries into the Electronic Health Record and the various county systems including, but not limited to: client searches, admissions, updating Payor Financial Information, change of diagnosis, demographics, and discharges.
• Ensures that the claiming of Medicare, Other Health Care coverage and client fees are processed timely and in accordance with proper procedures and internal controls.
• Coordinate to ensure all new staff and license changes are recorded in the Electronic Health Record and various county systems.
• Ensure Medi-Cal eligibility for all active clients have been completed in a timely manner and follow-up with Administrative staff as required.
• Manage the processing of approved and denied claims to include collaboration with administrative, program and clinical staff to resolve data entry related issues.
• Works with Office Managers to identify and prevent any cause of known denied claims and audit risks.
• Coordinates with data analyst to determine potential billing denial patterns and makes recommendations of necessary action plan to address such issues to Director of Revenue Management.
• Review, monitor and report status of claims on a weekly basis to ensure timely and accurate reimbursement.
• Conduct follow-up on outstanding claims and report any inconsistencies to the Director of Revenue Management.
• Ensure proper communication, documentation, and maintenance of claiming records in accordance with all appropriate licensing compliance and contract standards.
• Responsible for the documentation of Business Office work flows and assist in the development of procedures.
• Evaluates and recommends procedural changes to further streamline and improve accuracy of Business Office operations.
• Provides training to Office Managers and Administrative Staff on accurate claiming procedures.
• Maintains effective communication and supportive working relationship with business office staff, Program Directors, & other agency departments.
• Provides guidance and leadership to ensure staff are skilled in understanding the complex documentation and billing requirements associated with providing client care within a county contracted environment.
• Monitors and evaluates staff performance on an ongoing basis and provides feedback to staff regularly.
• Works with Office Managers to identify and prevent any cause of known audit risks.
• Serves as a strategic partner to the Director of Quality Assurance and Director of Revenue Management to ensure that the documentation of client care and billing is complete, processed in a timely manner and maintained in accordance with agency, county, state and federal standards.
• Documents work flows and develops training initiatives for new employees; for work teams, whenever standards or procedures change; and for those whose performance needs improvement.
• Knowledgeable with private insurance /HMO billing, related policies, regulations, submitting, adjudication, processing, and managing health care claims to ensure accurate and timely reimbursement

Position Requirements

• Prior experience managing line supervisors
• Experience overseeing revenue management or billing functions within a county/federally contracted or large medical billing function within a medical practice.
• Ability to analyze issues, identify key problems, and recommend potential solutions to resolve such issues.
• Demonstrated effective organizational skills, ability to plan effectively, and flexibly multi-task priorities as needed.
• Effective oral and written communication skills sufficient to write comprehensive reports and policies and deliver presentations. Strong interpersonal skills to interact with staff at all levels in a collaborative effort.
• Prior experience with information technology to improve and integrate various business systems required.
• A commitment to team objectives and Didi Hirsch philosophies
• Ability to adapt to changing needs by acquiring new skills and knowledge
• Current California driver’s license and a driving record acceptable to the Agency’s insurance carrier