Billing Supervisor Of Revenue Cycle Management

Planned Parenthood Northern California (PPNorCal) is seeking a Billing Supervisor of Revenue Cycle Management in our Concord Administrative Office. This role is full-time, 40 hours per week, on-site with flexible telecommuting. PPNorCal provides a comprehensive benefits package including 100% employer paid medical insurance for the employee, 50% employer paid medical insurance for dependent children, dental and vision coverage, employer paid life and long-term disability insurance, 15 days of paid time off to start, 10 paid holidays, and a 403(b) retirement plan with up to 4% employer match after 12 months of service.

SUMMARY

The Billing Supervisor of Revenue Cycle Management reports to the Director of Revenue Cycle Management and is responsible for managing all aspects of the day to day operations and performance of the billing department staff. This includes coding, billing, account receivable collection, and adjustments ensuring timely and accurate processing and reimbursement of claims. Generate and review billing department policies and procedures to uphold compliance with all applicable laws, regulations, and standards. Oversees Revenue Cycle billing related systems including patient management applications related to Revenue Cycle data, coding, billing, collections, and patient accounting.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

SUPERVISORY RESPONSIBILITIES

• Directly supervises the billing department employees. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.
• Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; reward, recognition, and disciplinary action; performance management of employees; addressing complaints and resolving problems.

Other Duties and Responsibilities

• Manages, trains, and staffs the billing, coding, and follow-up collection functions at PPNorCal.
• Tracks reimbursement of multiple contract rates, fee-for-service rates, etc. in billing department to include State, Federal, and Commercial insurance payors.
• Provides guidance and policy and procedures for coding, billing and follow-up collection staff related to payor and patient financial information including eligibility, authorization, co-pays and deductibles, charging, billing, and adjustments.
• Responsible for overseeing both the electronic (EDI) and manual (Paper) billing processes.
• Remains knowledgeable on California billing regulations for DHCS Medi-Cal, FPACT, PE4PW, EWC, Medi-Cal Managed Care Plans, in all PPNorCal Counties.
• Establishes lines of communication with Sr. Manager of Front Office Operations to ensure accuracy and confidentiality of patient accounting records.
• Assigns responsibility for investigation, follow-up, and collection of patient accounts.
• Performs billing department month-end close reporting of accounts receivable reports to ascertain status of collections and balances outstanding and to evaluate effectiveness of current collection policies and procedures.
• Reports findings to Director of Revenue Cycle and VP Finance monthly and as requested.
• Audits delinquent accounts considered to be uncollectible to ensure maximum efforts have been taken before assigning uncollectable write-off status to account.
• Responsible for reading and updating State and Federal procedures and codes necessary, including CPT4, HCPCS, and ICD-10 diagnosis codes.
• Compiles and analyzes statistical data on patient accounts for review by Director of RCM, and Revenue Integrity Analyst to assist in monitoring key productivity indicators.
• Monitors coders, billers, and follow-up collectors’ productivity activities to ensure maximum productivity and prepare periodic and annual evaluation of billing department staff through documentation of productivity, accomplishments, and error rates.

• Perform/coordinate/supervise timely, accurate billing of all Medi-Cal, Medicare and third-party payers, track and collect outstanding accounts receivable.
• Perform/coordinate/supervise Remittance Advise posting to assure accurate posting upon receipt.

• Create best practice tools, which include SOP, job aides, rebilling solutions, and correcting charge entry errors.
• Participate in Prop 56 payor reimbursement projects as they arise.
• Assist in determining billing requirements of new Managed Medi-Cal and/or Commercial insurance contracts; ensure correct coding.
• Assist in maintaining relationships with contracted payers.
• Coach and mentor billing department staff team members, create environment for knowledge transfer and cross-training and provide billing department staff with assistance in performing difficult or complicated duties.
• Report weekly to Director of RCM detailing accomplishments, areas for improvement, clear performance goals, and effectiveness of systems.
• Oversee and interact with team members regarding assigned administrative operations. Includes but is not limited to plan eligibility, fees, pre-authorizations, coding, billing, auditing, and claims follow-up.
• Work closely with EPIC Site Specialist, OCHIN analysts, and IT Staff on system issues.

• Evaluate billing and collections systems regularly and make recommendations for continued quality improvement.

• Participates in the Revenue Cycle Management and other committees as assigned.
• Ensure compliance with PPNorCal policies, as well as State, Federal and other regulatory bodies.
• Role-models and provides Leadership toward the implementation of PPNorCal Diversity, Equity, and Inclusion plan.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Possess a Certified Professional Coder (CPC®) or Certified Coding Specialist (CCS®) certificate from AAPC or AHIMA.
• 2 years coding experience preferred.
• Required knowledge of CPT4, HCPCS, and ICD10 coding a must.
• Knowledge of insurance eligibility, benefits and coverage required in the registration processes and procedures.
• EPIC EHR/EPM, EPIC – Resolute PB Billing, EPIC – Prelude, EPIC – EpicCare experience a must.
• Medi-Cal, FPACT and PE4PW billing experience required.
• Strong commitment to quality healthcare and excellent customer service.
• Strong managerial and mentoring experience.
• Knowledgeable in Community Clinic health care services.
• Excellent written and verbal communication skills.
• Ability to demonstrate mature judgment, initiative, and critical thinking.
• Ability to relate to diverse communities.
• Accuracy and attention to detail essential.
• Knowledge of California MediCal, MediCal Managed Care, Commercial PPO, and Medicare billing guidelines required.
• Maintain professional demeanor.

EDUCATION and/or EXPERIENCE

Associate Degree (A.A.) or equivalent from two-year college or technical school in healthcare administration or related field or equivalent or 4-6 years related supervisory experience supervising a billing department; or equivalent combination of education and experience. 1-2 years direct patient care in Health Clinic experience desired.

LANGUAGE SKILLS

Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

REASONING ABILITY

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

COMPUTER SKILLS

Knowledge of Microsoft Office Suite (Outlook, Excel, Word) and knowledge of EPIC Electronic Health Records/Electronic Practice Management systems experience required.

PROTECTED HEALTH INFORMATION (PHI) ACCESS REQUIREMENT

As required for client billing requirements.

CERTIFICATES, LICENSES, REGISTRATIONS

Certified Professional Coder (CPC®) or Certified Coding Specialist (CCS®) AAPC or AHIMA Certificate.

Pay Range: Planned Parenthood Northern California (PPNorCal) supports California’s new law (SB 1162) enhancing pay transparency. This new law requires employers with 15 or more employees to include a pay range in job postings. The pay range reflects the compensation that a new employee can expect to receive if offered employment. Employees with more experience, education, and other qualifying factors may be compensated at a higher rate of pay. The pay range for this position is: $60,000-70,200 annual salary.

Planned Parenthood Northern California is an equal opportunity employer and works affirmatively to include diversity among its staff and does not discriminate on the basis of race, color, ethnicity, religion, sex/gender identity, sexual orientation, national origin, age, disability, income, marital status, or any other irrelevant dimension of diversity. PPNorCal values collaboration between employees of diverse backgrounds and experiences.

We provide healthcare and education services to 137,000 adults and youth every year at 17 health centers located throughout 20 Northern California counties. Planned Parenthood Northern California offers high-quality, affordable health care to all, regardless of income, insurance, or immigration status. We care. No matter what!

Our experienced and caring medical staff gives each patient honest information and personal attention. We provide a full range of services, including birth control, breast exams, cancer screenings, medication and in-clinic abortion, pregnancy testing and counseling, prenatal care, PrEP, and nPEP to prevent HIV infection, STD screening and treatment, vasectomy and infertility services, gender-affirming hormone therapy, and more.