DMH Medical Billing Administrator, Robert Half

Robert Half

Location:
United States, Los Angeles

Category:
Health and Beauty

Contract Type:
Employment contract

Salary:

Not provided

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Job Description:

We are offering a permanent employment opportunity for a DMH Medical Billing Administrator at our healthcare establishment in Los Angeles, California. As a DMH Medical Billing Administrator, you will be primarily tasked with overseeing the submission and verification of medical claims for reimbursement, maintaining compliance with local, state, and federal regulations, and handling the management of denied and voided claims.

Job Responsibility:

Oversee and ensure accurate and timely submission of weekly billing to the Los Angeles County Department of Mental Health and third-party payers using EHR, EXYM, and Office Ally
Collaborate with the Quality Assurance Department to ensure the effective management of the electronic health record, EXYM
including billing, case closures, location, funding sources, and productivity updates
Continuously review, manage, and develop billing procedures to ensure compliance with regulatory standards
Utilize and apply Current Procedural Terminology (CPT) Codes where necessary
Recognize denial patterns and issues and promptly report them to management
Track data and generate reports as required
Ensure resolution of denied and voided claims, diligently following up until the claim is paid
Oversee the weekly download of SIFT Data, reviewing data for claim accuracy in DMH/IBHIS and EXYM systems
Collaborate and consult effectively with Clinical Quality Assurance, Mental Health, and other staff/programs to ensure adherence to policies and procedures
Generate and distribute management reports highlighting unfiled, pending, denied, and submitted claims
Maintain the highest level of billing standards following current guidelines from Medi-Cal, and other insurance entities
Understand the impact of mental health staff in electronic databases (NAPPA, NPPES) on billing accuracy and completion
Regularly check Medi-Cal eligibility for all clients, compiling a list of clients with terminated Medi-Cal as needed, and provide management reports
Attend internal and external meetings and trainings
Perform a variety of general clerical duties
prepare a variety of routine correspondence, forms, reports, and similar items using word processing and Excel Spreadsheet
Continuously develop and maintain claim resolution skills through ongoing trainings, workshops, and education

Requirements:

Possession of a minimum of 5 years of experience in a related role
Proficiency in Medical Billing is a must
Demonstrable experience in Medical Management
Prior experience as a Medical Manager is highly valued
Familiarity with Mental Health and Behavioral Health aspects
Knowledge and understanding of Medi-Cal procedures
Proven track record in Medical Collections
Expertise in the HealthCare Revenue Cycle is essential

What we offer:

medical, vision, dental, and life and disability insurance
eligibility to enroll in our company 401(k) plan

Additional Information:

Job Posted:
March 27, 2025

Employment Type:

Fulltime

Work Type:

On-site work

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DMH Medical Billing Administrator