Billing Manager

Northeast Community Clinic; Alhambra (CA); On-site; USD 75,000 - 85,000; Full time

Job summary

Northeast Community Clinic is seeking a Billing Manager to oversee the Billing Department at our Administration Office in Alhambra, CA. This role focuses on accurate claims processing, denials review, and ensuring timely revenue cycle operations.

The ideal candidate will have leadership experience in medical billing, knowledge of Medi-Cal guidelines, and bilingual Spanish/English capabilities, with willingness to travel between facilities and occasional evenings.

Qualifications

• Bachelor’s Degree in healthcare, finance, or related field or equivalent work experience.
• Diploma in Health Claims Examiner/Medical Biller.
• Experience in medical billing and coding is preferred (3+ years).
• Must have at least one year experience as a Medical Billing Manager.

Responsibilities

• Supervise Billing Department staff including supervisors and billers.
• Review claims for completeness and errors; correct as needed.
• Monitor submission of encounter data to health plans.
• Review denials and resubmit within 30 days.
• Manage billing for Medi-Cal, HMO, Medicare, and other funding sources.
• Run billing reports and maintain funding-source reports.
• Assist with gathering billing documents for audits.
• Inform managers of unbilled or go-back claims daily/weekly.

Skills

MS Office

Excellent communication

Customer service

Bilingual Spanish/English

Leadership

Travel readiness

Reliable transportation

Ability to travel between facilities

Education

Bachelor’s Degree in healthcare/finance or related field

Diploma in Health Claims Examiner/Medical Biller

Job description

Job Details: Job Location: Administration Office - Alhambra, CA 91801, Salary Range: $75,000.00 - $85,000.00 Salary, Travel Percentage: Up to 25%, Job Shift: Day, Job Category: Health Care, Position Summary

The Billing Manager oversees the Billing Department.

Schedule:

• Flexible, may require some evening and weekends
• Hours worked per week may exceed 40 hours

Primary Duties and Responsibilities

• Supervise and oversee the Medical Billing Supervisor, Medical Billing Lead, Medical Billers, and the Medical HCC Coder.
• Review all claims for completeness and errors and correct them accordingly.
• Monitor the submission of encounter data (HCFA 1500) to the appropriate health plans.
• Review all denials for complexity, make corrections, and resubmit claims within 30 days of the denial received date.
• Monitor the billing of the BCDP, CHDP, Medi-Cal, CPSP, PPP, EAPC, HMO, Medicare, and other funding sources.
• Responsible for running all billing reports, researching reports for re-bills, and maintaining report books by funding source.
• Assist with pulling all required medical billing documents needed for site sites for all clinics and administrative audits.
• Review weekly “billed” report with department manager.
• Inform clinic managers of “unbilled” or “go-backs” claims on a daily/weekly basis.
• Generate weekly revenue report status to management team.
• Other duties assigned by the Controller or Finance Director.

Qualifications: Minimum Requirements

• Microsoft Office/Word/Excel/Outlook
• Excellent Communication Skills, with the ability to interpret medical billing issues
• Excellent Customer Service Skills
• Knowledge of Medi-Cal reimbursement guidelines preferred
• Bi-lingual Spanish/English (preferred)
• Ability to relate well to the cultural and ethnic characteristics, as well, the population served by the organization
• Excellent Leadership Skills
• Reliable transportation
• Must be able to travel from facility to facility
• This position requires 10 % travel with frequent travel outside the local area. Some overnight and/or interstate travel.

Required Education/Experience and/or Licensure/Certification

• Bachelor’s Degree in healthcare, finance, or related field or equivalent work experience
• Minimum of three years’ experience in medical billing and coding experience
• Must have at least one year experience as a Medical Billing Manager
• Diploma in Health Claims Examiner/Medical Biller
• Commitment to goals and philosophy of Northeast Community Clinic
• Valid State Identification

Physical Requirements and Working Conditions

• OSHA Category 3 – Involves no regular exposure to blood, body fluids, or tissues, and tasks that involve exposure to blood, body fluids, or tissues are not a condition of employment.
• The work is majority of the time sedentary in nature.
• The employee is regularly required to communicate, frequently required to use repetitive motions, move, remain stationary, regularly push, pull and lift up to 20 pounds and occasionally push, pull and lift up to 40 pounds.
• Must possess mobility to work in a standard office/clinic setting (in some cases both settings) and to use standard office/clinic equipment, including a computer, stamina to maintain attention to detail despite interruptions, read printed materials and use a computer, and communicate in person and over the telephone.