We are recruiting a dynamic Revenue Cycle Billing Manager for a specialized healthcare provider in Sacramento. This is a full time, direct hire opportunity with a thriving organization that values work/life balance. This role is responsible for managing and monitoring all billing and collection processes, billing operations, and controls. Individuals with an accounting background and solid understanding of debits and credits will succeed in this position. Salary: Up to $100,000/year DOE.

The ideal candidate will have at least eight years of medical billing and insurance experience. This position requires strong managerial, leadership, and business office skills, including critical thinking and the ability to produce and present detailed billing activity reports.

RESPONSIBILITIES:

• Maintain current expert knowledge in billing and revenue cycle.
• Oversee the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.  
• Serve as the expert and go to person for all coding and billing processes.  
• Plan and direct patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection.  
• Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues.  
• Prepare and analyze accounts receivable reports, weekly and monthly financial reports, and insurance contracts. Collect and compile accurate statistical reports.  
• Audit current procedures to monitor and improve efficiency of billing and collections operations.  
• Ensure that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and follow Federal, State, and payer regulations, guidelines, and requirements.  
• Participate in the development and implementation of operating policies and procedures.  
• Analyze trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures.  
• Work with internal Administration and Partners to calculate and report company’s liabilities and receivables.   
• Supervise billing office personnel, which includes work allocation, training, and problem resolution; evaluate performance and makes recommendations for personnel actions; motivate employees to achieve peak productivity and performance.  
• Possible travel from main clinic to satellite clinics. 
• Perform other duties, as needed.

QUALIFICATIONS:

• Bachelor’s degree in finance or accounting required; or equivalent combination of education and experience. 
• 8 years’ experience in medical insurance and healthcare billing. 
• Management of at least 5-10 direct employee reports. 
• Collections experience in a medical practice or health system, with a deep understanding of medical billing rules and regulations. 
• Certified Coder certificate a plus. 
• Understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare; strong knowledge of California and Federal payer regulations.   
• Working knowledge of CPT and ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits, and appeal process. 
• Must have experience working with at minimum Medicare, Medi-Cal. 
• Thorough understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare; strong knowledge of California and Federal payer regulations.   
• Knowledge of healthcare policies for all clinical practices and applicable laws and regulations governing proper clinical practice; ability to demonstrate ethical behavior in diverse situations. 
• Experience with ASC (Ambulatory Surgical Center) coding regarding Pacer’s, ICD’s a plus. 
• Experience in UB facility billing for various private and Medi-Cal GMC based insurances.   
• Attention to detail, able to prioritize workload. 
• Able to work independently and as a member of a team. 
• Excellent written and verbal communications skills. 
• Strong organizational and planning skills. 
• Proficiency in MS Office and Patient Management software. 
• Bilingual preferred.