BILLING SUPERVISOR - CCSEP at Neighborhood House Association

Billing Supervisor

Under the supervision of the Program Director, the Billing Supervisor (BS) is responsible for overseeing and coordinating billing operations to support accurate and timely reimbursement for the program. Supervise BS and II and Office Assistant I and II. This position reviews and monitors electronic health record (EHR) billing data for accuracy, completeness, and compliance with County, State, and Medi-Cal requirements; identifies and resolves documentation and billing discrepancies; and serves as a liaison with the County Mental Health Billing Unit regarding claims, eligibility, and billing corrections. The Billing Supervisor provides technical guidance and training to staff, assists with reporting and workflow coordination, and supervises the day-to-day activities of billing support staff to ensure efficient program operations and compliance with applicable billing standards and regulations.

Examples of essential duties include:

• Generates and reviews routine EHR billing, service, and error reports to identify documentation, service entry, and charge errors
• Supervises Billing Specialist and Office Assistant day to day and completes timecards in a timely manner
• Assist with medical insurance enrollment, assist with Intake as needed.
• Oversees Fee-for-Service (FFS) billing operations to ensure accuracy, timeliness, and compliance with County and Medi-Cal requirements.
• Provides training and ongoing support to staff on SmartCare and other billing systems to ensure proper documentation and billing practices.
• Ensures program readiness for Medi-Cal certification, including preparation, coordination, and adherence to all regulatory and compliance standards.
• Reviews EHR data for accuracy, completeness, and compliance to support Medi-Cal reimbursable services
• Communicates with providers, supervisors, and program staff to resolve documentation and billing discrepancies in a timely manner
• Tracks, documents, and follows up on corrections to ensure accurate service records and compliance prior to billing submission
• Serves as liaison with the County Mental Health (MH) Billing Unit regarding billing corrections, eligibility concerns, submission of EOBs, and claim follow-up
• Assists in preparing monthly program, billing, productivity, and mileage reimbursement reports
• Provides technical guidance, training, and support to staff regarding EHR documentation and billing procedures to promote accurate and timely claim submission
• Supervises, assigns, reviews, and monitors the work of billing staff to ensure compliance with County, State, and Medi-Cal billing requirements
• Assists with staff onboarding, training, workflow coordination, and performance monitoring related to billing operations and documentation standards
• Collaborates with program leadership to improve billing processes, resolve operational issues, and support efficient program operations
• Completes all other duties as assigned by Program Director, Supervising Director and General Manager of Social Services.

Desired minimum qualifications include knowledge and ability of:

• Knowledge of medical and behavioral health billing practices, procedures, and reimbursement principles
• Understanding of Medi-Cal billing processes and workflows within County-operated or County-contracted behavioral health systems
• Knowledge of insurance eligibility verification, claims processing, and coordination of benefits involving Medicare and Other Health Coverage (OHC)
• Ability to generate, review, reconcile, and analyze EHR billing, service, and error reports to identify and resolve discrepancies
• Knowledge of clinical documentation standards and billing requirements necessary to support Medi-Cal reimbursable services
• Familiarity with HIPAA regulations, confidentiality requirements, and compliance standards related to protected health information
• Experience working with culturally diverse populations and understanding the cultural, socioeconomic, and systemic factors affecting adults experiencing serious mental illness, homelessness, co-occurring disorders, and criminogenic risk factors
• Ability to exercise sound judgment and make decisions within established policies, procedures, and guidelines
• Ability to communicate effectively both verbally and in writing with providers, staff, external agencies, and stakeholders
• Proficiency in the use of computers and software applications including word processing, spreadsheets, databases, and electronic health record (EHR) systems

Language skills include:

Ability to effectively present information and respond to questions primarily in English from managers, providers, County billing staff, clients, and the general public; demonstrated skills in clear, professional written and oral communication related to billing, documentation, and data correction issues. Bilingual proficiency in English and Spanish preferred.

Mathematical skills include:

Ability to add, subtract, multiply, and divide using whole numbers, common fractions, and decimals; ability to review units, dates of service, and billing data for accuracy and consistency.

Reasoning ability includes:

Ability to define problems, collect and review EHR and billing data, establish facts, and draw valid conclusions; ability to interpret technical billing instructions, compliance requirements, and documentation standards and apply them to service correction and billing support activities.

Experience and training includes:

High school diploma or G.E.D. required. A Bachelor's degree in Business Administration, Accounting, Public Health, Social Services, or a related field is preferred. Minimum of three (3) years of billing, clerical, or administrative experience in a healthcare, behavioral health, or social services setting is required, preferably within a County or County-contracted program. Experience supporting Medi-Cal billing processes and familiarity with County billing systems is strongly preferred. Experience using SmartCare or similar behavioral health electronic health record (EHR) and billing systems is highly desirable. Billing or financial certification and/or formal training is a plus. Bilingual proficiency is preferred. An equivalent combination of education, training, and experience may be considered.

Licenses, certificates & special requirements include:

A Valid Driver's License with current California automobile insurance; A Valid Cardiopulmonary Resuscitation (CPR) Certification; A valid Tuberculosis (TB) test upon hire and updated every two (2) to four (4) years depending on the County Contract requirements;

Physical and mental demands include:

While performing the duties of this class, an employee is regularly required to sit, stand and walk; talk or hear, both in person and by telephone; use hands to operate, finger, handle or feel office equipment; reach with hands and arms; and lift up to 30 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

While performing the duties of this position, employees are regularly required to communicate effectively both verbally and in writing; read, interpret, and apply information and documents; exercise problem-solving and organizational skills; learn and apply new procedures and information; and manage multiple detailed tasks simultaneously. The position requires the ability to work in a fast-paced environment with frequent interruptions, changing priorities, and deadlines while maintaining professionalism, patience, and a supportive approach when interacting with management, staff, vendors, program participants, including individuals with Serious Mental Illness (SMI), and members of the public who may at times be anxious, upset, or impatient.

Work environment includes:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this class. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Employees work under typical office conditions, and the noise level is usually quiet.