Patient Accounting Manager at County of Contra Costa

The PositionContra Costa Health is offering an excellent opportunity for two (2) Patient Accounting Managers within Contra Costa Health Plan (CCHP). CCHP is a federally qualified state-licensed and county-sponsored Health Maintenance Organization (HMO) serving Contra Costa County in the East Bay of the San Francisco Bay Area. Established in 1973 CCHP was the first county-sponsored HMO in the United States and today serves as the largest managed care health plan in Contra Costa County covering more than 250000 residents.CCHP is committed to providing equitable accessible and high-quality healthcare to our culturally and linguistically diverse members. Within CCHP the Patient Accounting Manager will serve as the manager of the CCHP Claims Department overseeing claims operations to ensure accurate and timely processing compliance with Medi-Cal Medicare and commercial payer requirements and alignment with the plans mission of supporting member and provider needs.Contra Costa Health Services (CCHS) the broader health system in which CCHP is housed is the largest department in Contra Costa County with more than 4000 employees providing integrated healthcare services and serving as the safety net for low-income and uninsured residents.We are looking for someone who is:Experienced in Managed Care: Brings direct experience in health plan claims operations within a managed care environmentKnowledgeable in Medicaid and Medicare: Understands Medi-Cal and Medicare program requirements including billing payment and complianceA Strong Communicator: Able to clearly explain complex billing and claims issues to staff providers and leadershipSolution-Oriented: Approaches challenges with a positive attitude and a commitment to continuous improvementProfessional and Collaborative: Excels at working in a team environment while maintaining accountabilityDiscreet and Judicious: Exercises good judgment in handling confidential and sensitive mattersSupportive: Invests in the training coaching and professional development of staffWhat you will typically be responsible for:Managing and supervising claims operations for CCHP including claims processing adjustments and payment integritySelecting training evaluating and monitoring the performance of subordinate personnel including supervisors and clerical staffOverseeing workflows to ensure timely and accurate adjudication of claims across Medi-Cal Medicare and commercial lines of businessServing as liaison with providers county healthcare staff and external stakeholders to resolve claims-related issuesEnsuring compliance with federal state and local regulations as well as managed care Medi-Cal and Medicare standardsMonitoring claims performance metrics including timeliness accuracy and compliance with DHCS (Department of Health Care Services) DMHC (Department of Managed Health Care) requirements and CMS (Center for Medicare and Medicaid Services)Reporting key claims issues trends and operational updates to higher management in a timely mannerCollaborating with Finance Utilization Management Compliance and other divisions to align claims operations with organizational goalsA few reasons you might love this job:You will have a direct role in ensuring providers are paid accurately and members claims are handled efficientlyYou will work in a dynamic environment with dedicated professionals focused on operational excellence and equityYou will help support CCHPs mission of providing high-quality healthcare to the countys most vulnerable populationsYou will be part of a collaborative experienced finance and claims team with well-defined processesWe offer generous benefits and a competitive retirement packageA few challenges you might face in this job:Adapting to constantly evolving federal state Medi-Cal and Medicare claims regulationsManaging multiple competing deadlines in a high-volume claims environmentProviding clear and effective communication when conflicts or discrepancies ariseMaintaining deep knowledge of complex billing and payment requirements across Medicaid Medicare and commercial insurance linesCompetencies Required:Delivering Results: Meeting organizational goals and customer expectations through accurate timely claims processingLegal & Regulatory Navigation: Understanding interpreting and ensuring compliance with laws and regulationsOwnership & Accountability: Holding self and others accountable for high-quality efficient resultsHandling Stress: Maintaining stability and composure under pressure or competing demandsOral Communication: Clearly explaining issues decisions and solutions to diverse stakeholdersInterpersonal Savvy: Building relationships and responding appropriately to the needs of othersLeadership: Guiding training and motivating staff to achieve departmental and organizational goalsRead the complete job description by clicking thislink.The eligible list established from this recruitment may remain in effect for six months.Minimum QualificationsEducation: Possession of a Bachelors degree from an accredited college or university with a major in business administration finance accounting health care administration or a closely related field.Experience: Three (3) years of full-time or its equivalent experience in an administrative managerial or supervisory position with direct responsibility for delivery of patient business services patient accounting services insurance billing services collection services or patient financial counseling services in a health care services organization.Substitution for Education:Possession of an Associates Degree or successful completion of sixty (60) semester or ninety (90) quarter units from an accredited college or university combined with two (2) years of full-time additional qualifying experience may be substituted for the required Bachelors degree; ORPossession and maintenance of one of the following professional certifications: Certified Healthcare Financial Professional (CHFP) issued by the Healthcare Finance Management Association (HFMA) or Certified Patient Account Manager (CPAM) or Certified Clinic Account Manager (CCAM) certifications issued by the American Association Of Healthcare Administrative Management (AAHAM); or Certified Patient Account Technician (CPAT) or Certified Clinic Account Technician (CCAT) combined with additional four (4) years of full-time qualifying experience may be substituted for the required Bachelors degree.Substitution for Experience and Education: Five (5) years of full-time or its equivalent experience as an Account Clerk Supervisor in Contra Costa County may be substituted for the required education and experience.Selection ProcessApplication Filing and Evaluation: Applicants will be required to complete a supplemental questionnaire at the time of application applications will be evaluated to determine which candidates will move forward in the next phase of the recruitment process.Remote Oral Assessment: Candidates who possess the minimum qualifications will be invited to participate in an online oral assessment. The assessment will measure candidates competencies as they relate to the the assessment candidates must achieve an average passing score of 70% or higher on each of the competencies as well as an overall passing score of 70% or higher. These may include but are not limited to: Delivering Results Legal & Regulatory Navigation Displaying Ownership and Accountability Handling Stress Oral Communication Oral Communication Interpersonal Savvy and Leadership. (Weighted 100%)TENTATIVE DATESRemote Oral Assessment: December 30-January 4 2025 The examination steps noted above may be changed in accordance with the Countys Personnel Management Regulations and accepted selection practices.For recruitment questions please contact Health Services Personnel Recruitment Team at. For any technical issues please contact the Government Jobs applicant support team for assistance at 1 . CONVICTION HISTORY After you receive a conditional job offer you will be fingerprinted and your fingerprints will be sent to the California Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI). The resulting report of your conviction history (if any) will be used to determine whether the nature of your conviction conflicts with the specific duties and responsibilities of the job for which you have received a conditional job offer. If a conflict exists you will be asked to present any evidence of rehabilitation that may mitigate the conflict except when federal or state regulations bar employment in specific circumstances. Having a conviction history does not automatically preclude you from a job with Contra Costa County. If you accept a conditional job offer the Human Resources department will contact you to schedule a fingerprinting appointment. DISASTER SERVICE WORKER All Contra Costa County employees are designated Disaster Service Workers through state and local law. Employment with the County requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned and to return to work as ordered in the event of an emergency. EQUAL EMPLOYMENT OPPORTUNITY It is the policy of Contra Costa County to consider all applicants for employment without regard to race color religion sex national origin ethnicity age disability sexual orientation gender gender identity gender expression marital status ancestry medical condition genetic information military or veteran status or other protected category under the law. Required Experience:Manager Key Skills Internal Audit,Supervising,Data Entry,Compliance,Customer Service,Accounting & Finance,General Ledger Accounting,IFRS,External Audit,Microsoft Excel,ERP,Payroll,Financial statement,ACCA,CPA Employment Type : Full-Time Experience: years Vacancy: 1 Yearly Salary Salary: 118044 - 143484