Job Description

Job Summary: Responsible for supervising and coordinating daily operations related to the billing, timely follow-up, and payment of Medicare/MediCal claims to achieve established financial and productivity goals. Considered the point person for staff, effectively monitors, supervises, audits, and mentors staff to ensure exceptional performance. Monitors payer performance/trends acting as a liaison with our Medicare Administrative Contractor (MAC)/our MediCal Intermediary and/or payer reps for long-term or ongoing account problems. Has overall responsibility for maintaining the daily integrity and accuracy of billing software and for ensuring their alignment with current billing regulations and the hospital's revenue cycle objectives. Provides input regarding policies, systems, methods, and procedures for the effective management and control of billing operations. May perform other duties as assigned.

Job Qualifications: High School or equivalent. Completion of the CMS Medicare/MediCal Billing certification program is to be completed with a passing percentage within 6 months of employment and re-certification annually thereafter. Two+ years Medicare billing and follow-up experience. Demonstrated understanding of revenue cycle processes and workflows, billing and reimbursement regulations, CERT, and RAC. Must have a working knowledge of medical terminology, CPT-4, HCPCS, ICD-9 and revenue codes. Must have strong analytical, investigational, and leadership skills, excellent oral/written communication and presentation skills, and demonstrated mastery of personal computers, MS Word, Excel, Outlook, and Internet Explorer applications.

[Preferred Qualifications]: Bachelor's Degree. Previous experience in an hospital setting; one year of supervisory experience. Past experience in denial management, performance improvement, root cause analysis, acute care/hospital information technologies within the Revenue Cycle.

Salary Range: $69,939 - $98,416 annually. Salary will be commensurate with experience. Pomona Valley Hospital Medical Center

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