Summary and Range of Authority:Under the direction of the Program Manager, Office Manager/Medical Records Manager will provide support to program operations by maintaining office systems and managing non-clinical daily operations of a county contracted mental health office. Additionally, this position engages in Medi-Cal and Medi-Medi Billing and interactions with insurance entities.
Essential Duties and Responsibilities
- Triage calls by answering questions about the program, document referrals, and/or provide basic referrals to community resources
- Processes all Admits and Discharges in Cerner
- Coordinate and manage requests for interpretation services
- Assists with managements of program caseload
- Prepare check requests as needed
- Prepare for payroll on a bi-weekly basis
- Will work with Program Manager and/or Program Director in obtaining and ordering office supplies and coordinate any required repairs of office equipment
- Act as a courier to deliver and pick-up mail between Program and other UPAC offices and funding sources as needed
- Prepares electronic schedule for MD appointments
- Opens the office and secures the office at the end of the day
- Participation in community outreach for the program
- Responsible for the overall management of the medical records billing units of the Community Wellness
- Entry of financial and insurance data for clients
- Reviews and communicates with 3rd party coverages and private insurances to resolve billing claims including obtaining denials to claims
- Auditing and resolving billing suspense issues
- Communicates with OPTUM and County Billing Unit to resolve any billing claims discrepancies and issues
- Utilizes Noridian and Office Ally to bill to Medi-Care for clients that are Medi-Medi
- Reviews Medi-Cal eligibility of clients
- Assists with data clean-up or data errors
- Responsible for all billing and collections of client accounts including insurance, government programs, and client payments
- Run reports on client financial and insurance status
Additional Essential Duties
- Performs financial eligibility screening for all clients and enters corresponding info in Cerner, County Electronic Medical Record system
- Responsible for the clerical management of the medical records, including creating charts, filing, faxing, duplication and archiving
- Enters data in various required databases, such as DCR and DES
- Performs weekly and monthly reports for quality assurance
- Complete projects assigned by Program Manager in a timely manner
- Ability to maintain strict confidentiality with regard to sensitive or proprietary information or materials
- Excellent interpersonal skills and ability to work well in a multicultural environment, including tact, diplomacy, patience and professionalism in dealing with individuals from a variety of backgrounds
- Experience with data entry, including use of Excel and/or other related database systems
- Ability to type and enter data accurately. Skilled in proofing and reviewing documents for accuracy and completeness
- Other duties as assigned.
Required Education, Certifications/Licenses and Language/Cultural Skills:
Minimum Experience and Qualifications Required:
- Two years’ experience in a similar position involving medical billing.
- Working knowledge and experience with data entry and information systems and computer applications including spreadsheets, database systems, computer languages, page design and layout, and formatting text
- Skilled in proofing and reviewing documents for accuracy and completeness
- Ability to type and enter data accurately
- Ability to work well under pressure
- Effective written and verbal communication skills
- Ability to maintain strict confidentiality with regards to sensitive or proprietary information or materials
- Ability to work well with the public
- Excellent interpersonal skills and ability to work well in a multicultural environment, including tact, diplomacy, patience and professionalism in dealing with individuals from a variety of backgrounds.
- Will not be debarred or excluded from participation in Federal programs by the General Services Administration and/or the Department of Health and Human Services of the Inspector General
- Must pass background check (Live Scan Fingerprint).
- Must be able to drive (when needed) for business purposes to other program locations in San Diego County. If employee drives his/her personal automobile for UPAC business, employee must have valid California driver’s license and comprehensive automobile insurance coverage, as required by law.
Physical Demands and Work Environment:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Spends approximately 70% of work time sitting and meeting with others or working at a desk and/or computer. Spends approximately 30% of work time standing or walking within the work area or outside the office at meetings and events, also bends, twists, stoops and reaches. Ability to communicate in writing and verbally. Regularly required to sit and talk or hear. Frequently is required to use hands to touch, handle or feel and reach with hands and arms. Occasionally lifts and/or moves up to 25 pounds. Working conditions are normal for an office environment, event venues and a commercial kitchen. The noise level is usually moderate.