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DMH Medical Billing Manager

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Robert Half

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Location:
United States, Los Angeles

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Category:
Health and Beauty

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Contract Type:
Employment contract

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Salary:

Not provided
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Job Description:

A DMH Medical Billing Manager is needed for Healthcare Organization in Los Angeles. The DMH Medical Billing Manager will review and verify through the use of reports that client records are complete for a successful transmission of medical claims for reimbursement from Department of Mental Health and private third-party providers. The DMH Medical Billing Manager is responsible for ensuring that information is processed accurately and timely, and is Familiar with concepts, practices, and procedures for all billing claims to Department of Mental Health (DMH) using the Electronic Health Record (EHR) software EXYM.

Job Responsibility:

  • Submit timely weekly billing to Los Angeles County Department of Mental Health and third party payers using EHR, EXYM and Office Ally
  • Collaborate with QA Department to oversee the electronic health record, EXYM
  • for billing, case closures, location, funding sources and productivity updates
  • Review, manage and develop billing procedures as needed to maintain compliance with local, state and federal regulations
  • Knowledge of use and application of Current Procedural Terminology (CPT) Codes
  • Identify and notify management of denial patterns and issues
  • Responsible for data tracking and reporting
  • Manage, track and resolve denied and voided claims, following through until claim is paid
  • Responsible for weekly download of SIFT Data. Review data for claim accuracy in DMH/IBHIS and EXYM systems
  • Collaborate and consult effectively with Clinical Quality Assurance, Mental Health and any other staff/programs to ensure adherence to policies and procedures
  • Generate and distribute statistical management reports to leadership, identifying unfiled, pending, denied, and submitted claims
  • Responsible for maintaining the highest level of billing standards following current guidelines from Medi-Cal, and other insurance entities
  • Understand how mental health staff in electronic databases (NAPPA, NPPES) affects billing accuracy and completion
  • Check Medi-Cal eligibility on a bi-monthly basis for all clients and compiling 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
  • prepares a variety of routine correspondence, forms, reports and similar items using word processing and Excel Spreadsheet
  • Develop and maintain claim resolution skills through continuous trainings, workshops and education

Requirements:

  • Candidate must possess a minimum of 5 years of experience in a relevant field
  • Proficiency in Medical Billing is a requisite for this role
  • Demonstrated experience in Medical Management is essential
  • The applicant should have prior experience as a Medical Manager
  • Knowledge and understanding of Mental Health issues is mandatory
  • Familiarity with Behavioral Health concepts is required
  • Expertise in Medi-Cal procedures is crucial for this role
  • Experience in Medical Collections is a necessary skill
  • Proficiency in managing the HealthCare Revenue Cycle is a must
What we offer:
  • Access to top jobs
  • Competitive compensation and benefits
  • Free online training
  • Medical insurance
  • Vision insurance
  • Dental insurance
  • Life and disability insurance
  • Company 401(k) plan

Additional Information:

Job Posted:
March 21, 2025

Employment Type:
Fulltime
Work Type:
On-site work
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