CVHI Specialist (Contract & Compliance Manager)

Paycom; Tustin (CA); On-site; USD 120,000 - 150,000; Full time

Job summary

Paycom's CVHI Specialist in California reports to the National Mental Health Support Coordinator, overseeing grant budgeting, financial reporting, and reconciliations while ensuring compliance with funding agreements.

You will coordinate managed care billing, maintain accurate financial records, supervise the Director of Clinical Services and others, and develop policies for grant operations and risk management.

Qualifications

• Bachelor’s degree from accredited college or university with at least 5 years of relevant experience.
• At least 5 years of experience with 3rd-party payers, coding, billing, posting, and adjudication of claims.
• At least 3 years of experience collecting, analyzing, and reporting financial data.
• Demonstrated knowledge about the HIPAA and HITECH acts and data protection.
• Excellent customer service and communication skills.
• Ability to work independently, as part of a team, and adapt to changing needs; veteran experience preferred.

Responsibilities

• Ensures compliance with the established funding agreement and monitors the CVHI grant’s fiscal operations.
• Oversees budgeting, accounts receivable/payable, reconciliations, and financial reporting.
• Coordinates the managed care billing process with 3rd party insurers to ensure compliance with policies.
• Maintains and monitors financial records for accuracy and regulatory compliance.
• Establishes policies for grant operations, risk management, and business continuity.
• Collaborates with staff on tracking financials, trends, and reporting; supervises administrative staff.

Skills

Financial analysis

Billing and revenue cycle

Grant management

HIPAA compliance

Leadership and supervision

Education

Bachelor’s degree

Job description

California Veterans Health Initiative (CVHI) SpecialistThe California Veterans Health Initiative (CVHI) Specialist reports directly to the National Mental Health Support Coordinator. This individual ensures compliance with established funding agreements while monitoring the fiscal operations of the CVHI grant including budgeting, financial reporting, and reconciliations. Key responsibilities include coordinating the managed care billing process, maintaining accurate financial records, and ensuring adherence to state, federal, and contractual policies. The CVHI Specialist also involves establishing and monitoring policies related to grant operations, risk management, and business continuity, as well as collaborating with staff on financial tracking and reporting. Additionally, the role directly supervises the Director of Clinical Services – CVHI (aka Clinical Director for the CVHI program), Intake Specialist, and will co-supervise the Outreach Specialist.FLSA Classification: ExemptResponsibilitiesEnsures that the program maintains compliance with the established funding agreement with CalVetMonitors the fiscal operations of the grant (i.e., budgeting, accounts receivables and payables, reconciliations, financial reporting, etc.) to ensure monthly expenses are accurateCoordinates the managed care billing process, including managing local relationships with 3rd party insurance and ensuring that services provided comply with contractual and reimbursement policiesMaintains and monitors all financial records to ensure accuracy, completeness of data, and compliance with state and federal rules and regulationsEstablishes and monitors policies and procedures pertaining to grant operations, risk management, and business continuity in the California Department of Veterans Affairs CVHI Notice of Funding AvailabilityEnsures policies and procedures are aligned with current grant and any applicable accreditation standardsCollaborates with staff around tracking financials, trends, and reporting, etc.Manages administrative staff to ensure all organizational standards are being followedPerforms other duties as assignedRequirementsBachelor’s degree from accredited college or university with at least 5 years of relevant experienceAt least 5 years of experience working with 3rd-party payers, coding, billing, posting, and adjudication of claimsAt least 3 years of experience collecting, analyzing, and reporting financial dataDemonstrated knowledge about the appropriate and effective use of protected health information, the Health Insurance Portability and Accountability Act of 1996 and the Health Information Technology for Economic and Clinical Health ActExcellent customer serviceMust been able to work independently, as part of a team, anticipate problems, generate solutions, and demonstrate flexibility and sensitivity when engaging with staff and clientsExcellent written and oral communication skills; ability to digest and distill complex subjects into clear messagesExperience working with military populations and/or veterans is strongly preferredValid driver’s license required and must be able to meet company insurance standards for drivers if applicable