Children's Bureau of Southern California
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IS Revenue Manager
at Children's Bureau of Southern California
Sunrise Center (Lancaster)
Mental Health Services
- Minimum Bachelor’s Degree in Business Administration or minimum of two years’ experience in Medi-Cal billing, Exym, or Department of Mental Health.
- Exceptional Computer literacy including Windows, Word, Access, and Excel required.
- Basic understanding of EDI and agency-based electronic health record system required.
- Two years’ experience with L.A. County DMH information systems preferred.
- Ability to assist in identification of QA trends via data analysis and QA technical audits.
- Strong team and organizational and time management skills.
- Demonstrated strong communication and interpersonal skills required.
- Ability to multi-task and perform general administrative duties.
- Ability to work in a multi-cultural environment required.
- Previous experience involving teamwork/team building to accomplish a common goal required.
REPORTS TO: Director of Revenue Management
This role’s primary purpose is to ensure that the Technological systems and the revenue generating systems are accurately performing to their optimal levels by communicating findings to Director of Revenuement Management and working with the appropriate staff and their supervisors. Additionally the Revenue Management will assist the Director of Revenue Management the resolution of revenue generating issues related to both in-house Systems and Los Angeles County Department of Mental Health IS System, with an emphasis on data interactions and data analysis as it relates to utilization management. Emphasis will include learning problem analysis, provision of direct user support for problems/questions resolutions, and/or the installation and configuration of computer hardware and software.
DUTIES AND RESPONSIBILITIES:
- Will be the primary source of assistance with regards to Exym, DMH, and Medi-Cal inquiries throughout Children's Bureau.
- Provide direct assistance to the Revenue and Office Support staff for billing related tasks such as Episode admission, Denied claims, Rejected claims, and Not Invoiced claims.
- Review and submit EDI claims through DMH’s EFT server. Revenue Management will also reconcile and research any billing discrepancy and report to Director of Revenue Management of any anomalies.
- Attend DMH trainings and meetings
- Create monthly Financial Workgroup Dashboard.
- Data mine in-house and EDI systems to ensure that all billing is being processed accurately and in a timely manner.
- Demonstrate the ability to understand and support the management of database systems within the department. Assists in project management for Improvement of Children’s Bureau Exym system.
- Provide supervisors with detailed reports from claims with problems identifying the discrete problem and the responsible party to fix the problem(s). Disseminates in-house reports to appropriate supervisors/managers and Director of Mental Health to notify any irregularities in data and also track trends related to these reports.
- Create and provider supervisors with summarized productivity report.
- Collaborates with UM supervisor on workflow and ensures that office-oriented directives and policies and procedures are implemented on a timely manner. In coordination with Director of Revenue Management, create all necessary procedure and guidelines to instruct the Revenue & Office Support staff ensuring that evidence the skill to conduct each aspect of their role and evidences the same to the UM supervisor.
- Identify system related obstacle to effective billing. Coordinate with appropriate staff and supervisors/managers to problem solve any/all obstacles to effective and timely billing.
- Maintains up to date information of any DMH IBHIS and EDI issues or changes and disseminate the information to appropriate staff.
- Coordinate with Department of Mental Health (DMH) to ensure that 100% compliance to state of California standards. Assists in monitoring data for identification of QA trends.
- Utilize and respond to problems noted in the tracking system. Log calls, attempt to resolve problems and route that information to QIC. Assist in coordination of data collection and data entry for Program evaluation.
- Maintains positive external contacts, attending DMH meetings and trainings related to program, including reporting to funding sources, community resources, collaborative partners, all issues related to IBHIS system and other related systems.
- Continue to expand and understand functions of Exym.
- Prepare for the changes to billing practices because of County IBHIS implementation.
- Continue to create expand, and understand the relationship and policies of Revenue Management.
- Maintains confidentiality in matters of agency operations, personnel, and clients.
- Maintains positive communications with all agency staff, clients and visitors.
- Exercise good judgment in performance of duties and responsibilities
- Supports existing agency policies, principles and mission.
- Other related duties as assigned.
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