Revenue Cycle Supervisor

Asian Health Services, founded in 1974, provides health, social, and advocacy services for all regardless of income, insurance status, immigration status, language, or culture. Our approach to wellbeing focuses on "whole patient health," which is why we provide more than primary care services, including mental health, case management, nutrition, and dental care to more than 50,000 patients in English and 15 languages: Korean, Lao, Burmese, Mandarin, Cantonese, Spanish, Portuguese, French, Mien, Karen, Mongolian, Karenni, Tagalog, Khmer, and Vietnamese. We offer medical, dental, and mental health services for all ages.
Job Summary: Under the supervision of the Revenue Cycle Managers (RCM), the Revenue Cycle Supervisor (RCS) is responsible for high-level medical billing processes and problem resolution. The RCS possesses a high level of knowledge and skills in billing to Medicare and Medicaid, Managed Care plans, and other insurance billing, CPT codes, and ICD-10. The RCS has a working understanding of medical terminology and HIPAA compliance rules and regulations, maintaining a high level of accuracy, integrity, and timeliness of financial reporting and internal controls. The RCS participates in analyzing and resolving department-wide issues, including operational workflows and EHR/EPIC system-related matters. The incumbent in the position will work in close partnership with the Revenue Cycle Managers and department staff to achieve the essential job functions and will advise, train, and mentor the Revenue Cycle Specialist and Assistants.
\n Essential Job FunctionsReview and analyze charges and payments posted by RC staff. Correct staff errors and, when necessary, provide training or re-training on procedures. Be able to direct staff and obtain helpful resources when needed.Monitor, review, and inform RC staff when payors' charges/CPT codes are not billed correctly and require follow-up.Assist the RCM to ensure the correct NPI number is used with the appropriate insurance carrier.Assist the RCM in monitoring EHR work queues.Work with the RCM to identify and resolve issues, troubleshoot problems, and produce necessary reports when requested.Assist with providing patient revenue information for the annual external audit.Act as a department resource for guidance, direction, and other information needed by department members.Perform FQHC & FFS Billing for Medicare, Managed Care, Medi-Cal (for primary care, IBH/BH Behavioral Health, and SMH Medicare). Follow up on denied or rejected claims and aging reports promptly.Verify Medicare eligibility in detail, ensuring the correct preventive G codes are used and updated in EPIC.Handle Medicare retroactive patients by sending new claims and processing refunds for incorrect payments.Use the Medicare Inovalon web and DDE System to correct/adjust claims, submit new claims, and cancel claims if necessary.Generate and submit Medicare Credit Balance Reports quarterly.Provide necessary support to staff when they encounter problems or difficult issues related to patient accounts. The RCS has the authority to approve or make billing adjustments as needed.Participate in staff meetings as appropriate (e.g., meetings with managers of Member Services and Support Services, cross-component meetings, etc.). Assist in ensuring effective communication within the department.Serve as a liaison between the Billing Department and clinic staff, PRS, Membership, and Patient Navigators on EPM matters.Stay updated on new information related to Medi-Cal, Medicare, Managed Care, and other third-party billing.Serve as a backup to the RCM in preparing monthly, quarterly, and annual billing reports.Perform other related duties as required by the supervisor.Let me know if you need additional adjustments! General Agency/AHS DutiesFoster an environment that promotes trust and cooperation among clients and staff.Enforce clinic policies and procedures, including maintenance of client confidentiality under HIPAA privacy rules, to ensure that the principles of AHS are implemented.Play an active role in planning organization-wide activities such as AHS general membership meetings, fundraisers, special clinic days, and other events.Participate in general membership meetings, fundraisers, and other public events, as required.Engage in outreach activities, agency advocacy, and serve on ad hoc committees, as requested.Attend AHS staff retreats and Board of Directors meetings, as required.Participate in agency-wide quality improvement program processes and performance improvement teams to ensure excellence in the quality of services provided across the agency.Foster an environment that promotes trust and cooperation among clients and staff.Enforce clinic policies and procedures, including maintenance of client confidentiality under HIPAA privacy rules, to ensure that the principles of AHS are implemented.Play an active role in planning organization-wide activities such as AHS general membership meetings, fundraisers, special clinic days, and other events.Participate in general membership meetings, fundraisers, and other public events, as required.Engage in outreach activities, agency advocacy, and serve on ad hoc committees, as requested.Attend AHS staff retreats and Board of Directors meetings, as required.Participate in agency-wide quality improvement program processes and performance improvement teams to ensure excellence in the quality of services provided across the agency. Minimum QualificationsA Bachelor's degree from an accredited college or university.Two years of medical billing experience or any equivalent combination of education and experience.Experience resolving billing issues with insurance companies.Experience using EPM/EHR software.Experience with FQHC/Managed Care billing. Preferred QualificationsExperience in developing billing office operations, including billing systems and procedures.Experience with OCHIN/EPIC EPM/EHR software.General knowledge of accounting principles.Ability to report data using any query language or report generator.General knowledge of accounting principles. Knowledge, Skills & AbilitiesProficiency with Microsoft Office applications, with intermediate to advanced level competency in Excel and PowerPoint.Ability to work collaboratively with other AHS supervisors and managers with a focus on customer service and quality of care, exemplifying the core values and mission of the organization, always exercising utmost discretion, diplomacy, and tact in patient/staff interactions.Knowledge of Medi-Cal, Medicare, and private insurance regulations and billing practices.Knowledge of laws and regulations governing collection procedures.Ability to read, interpret, and explain laws and regulations related to billing and collections.Ability to gather, assemble, analyze, and evaluate facts, draw logical conclusions, and make appropriate recommendations.Ability to effectively communicate with the patient population and staff while demonstrating a high degree of diplomacy and tact.Basic working knowledge of medical terminology.Ability to exercise initiative, judgment, discretion, and decision-making to achieve organizational objectives. Effective supervisory skills to oversee direct reports and delegate responsibility and authority to staff.Demonstrated attention to detail and well-organized.Ability to multi-task, prioritize, and meet deadlines.Strong written and verbal communication skills.Advanced financial accounting analysis and reporting skills.Knowledge of budgeting and preparing financial reports.Proficiency with Microsoft Office applications. Physical & Work DemandsThe physical demands described here are representative of those that must be met by an employee to successfullyperformthe essentialfunctions of this job. Reasonable accommodations maybe made toenable individuals with disabilities to perform the essential functions.Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The position is a well-lighted office environment with occasional evening and weekend work.It involves sitting approximately 90 percent of the day and walking or standing for the remainder.
\n$85,312.50 - $87,945 a year
\nBENEFITS: Medical, Dental, Vision premiums 100% paid by AHS
12 Vacation Days
12 Sick Days
12 Holidays and 3 Floating Holidays
3% 403B Employer Contributions and up to 2% Employee Match Contribution
Transportation Benefit Paid by AHS
FSA/Dependent Care Assistance
Long Term Disability