Revenue Cycle Manager - Ambulatory Care

Job Description:

Revenue Cycle Manager - Ambulatory Care

Description

Description

The Revenue Cycle Manager will collaborate with the Assistant CFO to ensure accuracy and proper processing of all billing functions. This position supports the organization's mission, vision, and values through excellence, competence, collaboration, innovation, respect, commitment to the community, and accountability.

THE IDEAL CANDIDATE: The ideal candidate for this role is a collaborative leader with excellent communication skills and a demonstrated ability to streamline processes and drive standardization initiatives. They excel in fostering teamwork, facilitating effective communication channels, and implementing solutions that enhance operational efficiency. With a proactive approach to process improvement, they possess a keen eye for identifying optimization opportunities and the strategic acumen to implement sustainable solutions. They are passionate about driving continuous improvement efforts and possess a track record of success in achieving tangible results.

PAYROLL TITLE: Staff/Services Manager II/III

APPROXIMATE SALARIES:
Staff/Services Manager II - $3,652.01 - $5,113.31 Biweekly
Staff/Services Manager III - $3,917.57 - $5,485.14 Biweekly

DEPARTMENT/AGENCY: Health Care Agency - Ambulatory Care

EDUCATIONAL/BILINGUAL INCENTIVE: Possible educational incentive of 2.5%, 3.5%, or 5% based on completion of Associate's, Bachelor's, or Master's degree. Incumbents may also be eligible for bilingual incentive depending upon operational need and certification of skill.

Staff/Services Manager II and III are Management classifications and are not eligible for overtime compensation. Incumbents in these classifications are eligible for benefits at the MB3 level.

The eligible list established from this recruitment may be used to fill current and future Regular (including Temporary and Fixed-term), Intermittent, and Extra Help vacancies for this position only. At this time, there is one (1) Full Time/Regular position with the Ambulatory Care Department.

NOTE: If appointed at the lower level, incumbent may be promoted to the higher level without further examination upon meeting the minimum requirements, demonstrating satisfactory performance, and in accordance with the business needs of the department.

TENTATIVE SCHEDULE
OPENING DATE: April 3, 2025
CLOSING DATE: Continuous and may close at any time; therefore, the schedule for the remainder of the process will depend upon when we receive enough qualified applications to meet business needs. It is to your advantage to apply as soon as possible.

Examples Of Duties

Duties may include but are not limited to the following:

• Oversees denial prevention activities for ambulatory care, including eligibility denials and billing holds;
• Supervises ambulatory care’s billing team, including performing evaluations and making recommendations for career development;
• Reviews aging report and KPIs with the billing staff routinely to ensure unbilled activity and aging goals are met while recommending improvements based on trends;
• Evaluates billing errors and provide updates and training recommendations to stakeholders;
• Regularly meets with Ambulatory Care COO and VCMS Revenue Cycle Director to provide updates and recommendations regarding departmental performance;
• Analyzes and maintains appropriate eligibility and billing procedures to ensure compliance with fiscal policies;
• Conducts meetings on a regular basis with the ambulatory care billing, management, and clinic staff to discuss any procedural changes, as well as to keep team informed of changes to coding, health plans/programs or other regulatory requirements;
• Conducts monthly meetings with ambulatory care billing team to discuss workflow, goals, and development opportunities while engaging the PFS Team to ensure topics align with reporting metrics;
• Prepares and evaluate revenue cycle reports (such as monthly reports, ad hoc reports, etc.) in order to analyze the billing functions and accounts receivable and make recommendations to the CFO and leadership as needed;
• Maintains regular communication and coordination with central billing team;
• Attends, conducts, and/or facilitates inter-departmental meetings to optimize workflows for all revenue cycle related matters;
• Creates updates training and documentation related to billing. Coordinates training and support for staff members and keeps up to date with state programs, specialty programs, and third-party payers billing guidelines and updates;
• Identifies and monitors compliance of coding and billing of all interdepartmental functions, services, supplies, medications, and overall other revenue cycle-related areas;
• Assists with monitoring and review of ambulatory care charge master to ensure it is updated with new and expired activity. Monitor charges and various reporting to ensure updates are appropriate and are made timely; and
• Performs other related duties as required.

Typical Qualifications

These are entrance requirements to the exam process and assure neither continuance in the process nor placement on an eligible list.
EDUCATION, TRAINING, and EXPERIENCE:
Any combination of education and experience which has led to the acquisition of the required knowledge, skills, and abilities.

The required knowledge, skills, and abilities can typically be obtained by:

Staff/Services Manager II: Five (5) years of experience in financial operations related to billing and collecting revenue for medical or health services which includes (3) years of supervisory experience that includes writing performance evaluations.

Staff/Services Manager III: Seven (7) years of experience in financial operations related to billing and collecting revenue for medical or health services which includes (4) years of supervisory experience that includes writing performance evaluations.

NECESSARY SPECIAL REQUIREMENTS:

• Possession and maintenance of a California driver license throughout the course of employment
• Previous experience in hospital admitting, outpatient, primary care, or specialty clinic setting
• Previous experience working with any of the following state programs and rules:
  • Medi-Cal Programs, including Medi-Cal Managed Care
  • Commercial Insurance
  • Medicare

DESIRED:

• Bachelor's degree in business administration, health sciences, or a related field.
• Possession of a coding certificate
• Knowledge of Federally Qualified Health Center (FQHC) system
• Experience using Electronic Health Records, particularly Cerner and Epic

Knowledge, Skills, and Abilities:
Considerable (Level II) to thorough (Level III) knowledge of:

• medical reimbursement programs and complexity of payment systems
• Current Procedural Terminology Codes (CPT), practice management systems and electronic health records systems, preferably Cerner
• International Classification for Diseases (ICD)-10 codes, Health Care Procedure Coding System (HCPCS) codes for payment processing of Medicare and/or Medi-Cal
• Medi-Cal Provider Manual for Billing and Policy and Program and Eligibility
• outpatient, primary care, and specialty clinic operations
• Microsoft Excel functions
• Eligibility and prior authorization requirements/process for commercial and government payors

Working ability to:

• analyze administrative and fiscal problems
• prepare a variety of reports and recommendations
• speak effectively in public
• plan, organize, and supervise the work of others; and
• safely drive a vehicle

Recruitment Process

FINAL FILING DATE: This is a continuous recruitment and may close at any time; therefore, apply as soon as possible if you are interested. Your application must be received by County of Ventura Human Resources in Ventura, California, no later than 5:00 p.m. on the closing date.

To apply on-line, please refer to our web site at ventura.org/jobs . If you prefer to fill out a paper application form, please call (805) 654-5129 for application materials and submit them to County of Ventura Human Resources, 800 South Victoria Avenue, L-1970, Ventura, CA 93009.
Note to Applicants: It is essential that you complete all sections of your application and supplemental questionnaire thoroughly and accurately to demonstrate your qualifications. A resume and/or other related documents may be attached to supplement the information in your application and supplemental questionnaire; however, it/they may not be submitted in lieu of the application.

LATERAL TRANSFER OPTION: If presently permanently employed in another "merit" or "civil service" public agency/entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a "merit" or "civil service" style examination, then appointment by "Lateral Transfer" may be possible. If interested, please click here for additional information.

SUPPLEMENTAL QUESTIONNAIRE - Qualifying: All applicants are required to complete and submit the questionnaire for this exam at the time of filing. The supplemental questionnaire may be used throughout the exam process to assist in determining each applicant's qualifications and acceptability for the position. Failure to complete and submit the questionnaire may result in the application being removed from consideration.

APPLICATION EVALUATION - Qualifying: All applications will be reviewed to determine whether the stated requirements are met. Those individuals meeting the stated requirements will be invited to the written examination.

TRAINING & EXPERIENCE EVALUATION: A Training and Experience Evaluation (T&E) is a structured evaluation of the job application materials submitted by a candidate, including the written responses to the supplemental questionnaire. The T&E is NOT a determination of whether the candidate meets the stated requirements; rather, the T&E is one method for determining who are the better qualified among those who have shown that they meet the stated requirements. In a T&E, applications are either scored or rank ordered according to criteria that most closely meet the business needs of the department. Candidates are typically scored/ranked in relation to one another; consequently, when the pool of candidates is exceptionally strong, many qualified candidates may receive a score or rank which is moderate or even low resulting in them not being advanced in the process.

ORAL EXAMINATION - 100%: A job-related oral examination may be conducted to evaluate and compare participating examinees' knowledge, skills, and abilities in relation to those factors which job analysis has determined to be essential for successful performance of the job. Examinees must earn a score of seventy percent (70%) or higher to qualify for placement on the eligible list.

NOTE: The selection process may consist of an Oral Exam, which may be preceded or replaced with the score from a Training and Experience Evaluation (T&E), contingent upon the size and quality of the candidate pool. In a typical T&E, your training and experience are evaluated in relation to the background, experience and factors identified for successful job performance during a job analysis. For this reason, it is recommended that your application materials clearly show your relevant background and specialized knowledge, skills, and abilities. It is also highly recommended that the supplemental questions within the application are completed with care and diligence, using proper grammar and complete sentences to showcase your writing skills. Responses such as "See Resume" or "Refer to Resume" are not acceptable and may disqualify an applicant from further evaluation.
If there are three (3) or fewer qualified applicants, a T&E or an Oral Examination will not be conducted. Instead, a score of seventy percent (70%) will be assigned to each application, and each applicant will be placed on the eligible list.

Applicants successfully completing the exam process may be placed on an eligible list for a period of one (1) year.

BACKGROUND INVESTIGATION: A thorough pre-employment, post offer background investigation which may include inquiry into past employment, education, and driving record may be required for this position.

For further information about this recruitment, please contact Nathan Wood by e-mail at nathan.wood@ventura.org or by telephone at (805) 677-5232.

EQUAL EMPLOYMENT OPPORTUNITY
The County of Ventura is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.

YOUR BENEFITS AS A COUNTY OF VENTURA EMPLOYEE

MANAGEMENT

To learn more about Benefits, Retirement, and the Memorandum of Agreement (MOA), see links below.

• Benefits website or you may call (805) 654-2570.
• Retirement FAQ's
• Memorandum of Agreement

Union Codes:MB3, MB4, MS, MT,MCC, MU

Closing Date/Time: Continuous

Salary:

$94,952.16 - $142,613.65 Annually