Job Details

“Every person deserves compassion, dignity, and the safety of a place to call home.”

Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care centers, emergency shelters, housing services and children's and family programs. IF currently has 13+ facilities with 22+ micro-communities scattered across Orange County, Los Angeles County and the Inland Empire.

The Medical Billing Manager is responsible for providing leadership to the billing department to ensure the accuracy of claims submission and collections. The Medical Billing Manager job description entails ensuring policies and procedures are adhered to, as well as fine-tuning effective billing processes for improvement. In addition, the Medical Billing Manager serves as a liaison between the claim specialists and the Associate Medical Billing Director to ensure department needs are met.

The pay rate for this role is $32-$34 per hour.

The schedule for this role is a hybrid schedule with Monday/Wednesday in office and Tuesday/Thursday/Friday WFH. 8:00am - 4:30pm.

CalAIM Billing and Follow up:

1. Perform as a practice expert at the department on all issues relating to billing processes.
2. Assist in training new staff members as needed.
3. Carry out performance evaluation of personnel and recommend necessary actions in collaboration with Associate Director of Medical Billing.
4. Ensure the billing department carries out all its activities in accordance with its overall protocol, and that they comply with payer, State, and Federal requirements, regulations, and guidelines.
5. Review and follow up on monthly billing sheets post completion to highlight and share with corresponding departments for corrections.
6. Monitor aging and facilitate escalations as needed with health plan providers.
7. Coordinate time away requests of team members to ensure the daily functions of the department are not negatively affected.
8. Post ERA's/ EOB's, submit claims and mail outs, follow-up on denials, rejections, and pending insurance claims.
9. Collaborate with other departments to obtain and review client and service-related information.
10. Assist with audits, reconciliations, reports as needed by the Associate Director of Medical Billing, VP of Finance, CFO, COO, and CEO.
11. Review claim submission and ensure all health plan guidelines and requirements are met.
12. Review and train claims department team on any contract updates and/or amendments as needed.
13. Give report of all concerns and issues at the department to the Associate Director of Medical Billing for prompt action.
14. Responsibilities subject to change upon company needs.

Communication and Skills:

1. Communicate with tact and professionalism.
2. Be able to meet targets and work under pressure with a high volume of claims.
3. Maintain knowledge of industry standard CMS guidelines for Billing.
4. Must be motivated to work independently as well as in a group setting.

Minimum Qualifications/Preferred Experience:

1. High School Diploma or equivalent.
2. 2-3 years' relevant experience.
3. Basic computer skills, including the ability to send and receive emails and summarize data in spreadsheets.
4. Prior experience working in Electronic Billing Platforms and EHR systems.
5. Prior experience working with claims and communication with health networks.
6. Prior supervisory experience.
7. Experience in Medical Billing and Primary Care Billing.
8. Proficiency in Microsoft (Mail, Docs, Sheets, Calendar).
9. Associate's degree or higher.
10. Medical Billing Certificate.
11. CalAIM Billing Experience.

Benefits

• Medical Insurance funded up to 91% by Illumination Foundation (Kaiser and Blue Shield), depending on the plan.
• Dental and Vision Insurance.
• Life, AD&D and LTD Insurance funded 100% by Illumination Foundation.
• Employee Assistance Program.
• Professional Development Reimbursement.
• 401K with Company Matching.
• 10 days holiday PTO/year.
• Paid vacation and sick days.
• Potential eligibility for the Public Service Loan Forgiveness Program (PSFL) for federally qualified loans.