Responsibilities
-
Supervise billing coordinators daily — queue assignments, workflow oversight, and productivity.
-
Conduct first-line quality review on flagged claims; enforce documentation and coding standards.
-
Monitor payer timely filing windows; ensure no claim expires due to late submission.
-
Own denial triage, assignment, and resubmission workflow; escalate systemic trends to the Manager with root cause documentation.
-
Drive AR follow-up across the team with focus on 30+ and 90+ day buckets.
-
Support weekly AR reconciliation, rate validation, and month-end close activities.
-
Enforce note-lock compliance with Clinical Operations; run month-end sweep to close with zero unbilled encounters.
-
Lead daily huddles and weekly 1:1s; deliver coaching, written feedback, and performance documentation.
-
Partner with the Manager on coordinator onboarding and ongoing training.
-
Step in to produce claims, work denials, and follow up on AR when volume or staffing requires; maintain audit-ready records.
Skills Required
-
Production-level proficiency in Office Ally and Availity — able to step into any coordinator queue and execute.
-
Working knowledge of eClinicalWorks (eCW) or comparable EHR.
-
Full command of the claim lifecycle: eligibility, coding, modifiers, submission, denial, appeal, and posting.
-
Medi-Cal billing rules; experience across ECM, CalAIM, and managed care programs.
-
Microsoft Excel and Google Workspace for AR, production, and denial reporting.
-
Proven ability to supervise, coach, and hold staff accountable while maintaining personal production.
-
Written communication for coaching documentation, denial appeal letters, and payer correspondence.
Preferred Qualifications
-
Direct experience in ECM, CalAIM, or Community Supports.
-
Familiarity with IEHP, Molina, CalOptima, Health Net, and Anthem portals and requirements.
-
Experience with capitated PMPM and per-encounter billing models.
-
Experience reading Power BI or comparable BI dashboards.
Competencies
-
Team leadership — holds coordinators to production and quality standards; models expectations through direct execution.
-
Operational discipline — runs the queue, closes the day, owns the week.
-
Payer fluency — maintains current knowledge of each health plan’s rules and timelines.
-
Analytical rigor — reads production and denial reports; identifies patterns and proposes fixes.
-
Execution under pressure — month-end close, payer deadlines, audit requests.
-
Integrity — will not submit or allow a claim that cannot be supported by documentation.
Requirements
Job Requirements
-
Education: Associate’s degree in business, healthcare administration, or related field required; Bachelor’s preferred. Equivalent RCM experience considered.
-
Experience: Minimum 3 years of current, hands-on RCM billing experience required — claim submission, denials, appeals, and AR. Minimum 1 year supervisory or team lead experience over billing staff required. Medi-Cal or managed care experience preferred.
-
Certification (preferred): Revenue cycle or billing credential preferred.
-
Schedule: Monday through Friday, 8:30 AM – 5:00 PM PST (required, non-negotiable).
-
Travel: None. Fully remote within California.
-
Location: California residency preferred.
-
Compensation & Benefits: Range set by People Team, commensurate with experience. Full benefits included.
Benefits
- Medical, dental, and vision insurance
- Paid time off + holidays
- Competitive pay
- Remote work flexibility
- Professional growth and development opportunities