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Director of Billing & Contracts
| Company | Vista Del Mar |
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| Location | Los Angeles, CA, USA |
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| Salary | $100000 – $130000 |
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| Type | Full-Time |
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| Degrees | |
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| Experience Level | Senior |
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Requirements
- Billing Experience
- Claims experience – In PSYCH/MENTAL HEALTH is a preference. NO (commercial, banking, retail will not be considered)
- Department of Mental Health
- CAL-AIMS Program
Responsibilities
- Distribution of work assignments, staffing, supervision, monitoring and evaluating of all staff and services under Quality and Compliance
- Manages the reconciliation of the agency’s DMH contract ensuring timely reporting of revenue, monitoring the claim denials and voids. Ensures accuracy of all claims submitted regarding procedure, funding and credential codes. Provides revenue, utilization and ad hoc reports to staff and works with programs to maximize funding challenges. Works with agency leads and DMH Contract Monitoring and Management Division providing reports as needed to request funding shifts or additional funds.
- Oversees Contracts Compliance Manager to ensure that contracts related to clinical services and programs are monitored for compliance, negotiation for individual client contracts with other counties and entities are completed timely, and that new opportunities are monitored and shared with staff for review and consideration.
- Manages DMH Quality Assurance and Revenue Management compliance projects that include, but not limited to, Medi-Cal Certification of all program sites, Annual Quality Assurance Reporting and Void Reports. Provides claims, revenue and credential reporting back up as needed for DMH compliance reporting.
- Oversee the Financial Manager ensuring revenue from all QSC responsible contracts is recorded accurately and timely to accounting, budgets for negotiated individual client contracts accurately reflect services to be provided and billed timely.
- Oversee Regulatory Compliance and Health Information Manager and the responsibilities for development and maintenance of the agency’s electronic health record systems, the functions of the Quality Assurance Programs and the establishment of protocols for effective maintenance and monitoring of clinical case records. Ensures client PHI is maintained in compliance with HIPAA standards and accreditation requirements.
- Oversee performance improvement tasks identified and developed around quality assurance and contract compliance issues ensuring they are developed, implemented and completed timely, that trends and results are used for program improvement, that VDM is HIPAA compliant, and that the Agency is audit ready for all contract and accreditation reviews.
- Oversee the Billing Manager and the management of client information and claims submission to Insurance and Contracts accurately and in compliance with contractual obligations, including the correction and resubmission of rejected, denied and unbilled claims.
Preferred Qualifications
- College degree preferred but mandatory.
