• Manages and directs the retrieval, approval and correction of claims as they come through the EHR to the Practice Management System. Posting of patient charges, payments and adjustments on automated system.• Reconciles charges, payments and adjustments posted to system.• Verifies and corrects patient information and demographics by performing internal audits• Works closely with all stakeholders and billing personnel to assure the accuracy and integrity of the accounts receivable system.• Conveys fiscal detail to the CEO, COO and CFO as well as working closely with a c-suite level• Monitor the billing activity to Medicare, Medicaid, CHDP, CDP and all other insurance companies• Monitor the generating of patient statements and collections of all accounts• Ascertains that all third-party denials are re-billed or, if appropriate adjusted.• Helps prepare yearly cost reports for all entities of financial audits, Medi-Cal, Medicare and UDS• Works with Clinical Operations staff and insure that any new programs and services are billable.• Creates special statistical reports as required on a daily, weekly and monthly• Create audit tool for coders when reviewing progress notes and address findings • Creates and assures compliance with billing procedures pertaining to business office needs.• Designs and updates business forms as necessary.• Responsible for Revenue to turn around rapidly as well as responsible for monthly capitation adjustments and reporting to ensure capitation payment• Communicate weekly with clinic manager on all errors and issues caused by front desk• Assists in staff training related to business office and registration functions.• Trains, supervises and evaluates Patient Account Representatives, Credentialing Coordinator, Analysts and Posting Clerks. • Trains, supervises and evaluates the process and documents submitted by the Credentialing Coordinator.

• Managing Physician patient account activities, billing, and collections, ensuring accuracy, completeness and the highest quality of data according to all regulatory standards (including HIPAA), and in compliance with grants and contracts. Supervising and leading staff with integrity, professionalism and service• Management of a staff of eight• Minimized outstanding AR from over 300 days to 120 days and under• Project Champion of the ICD-10 implementation for Medical, Behavioral and Dental• FQHC knowledge as well as multiple County and State programs such as EWC, FAM Pact, DMH and CHDP among other temporary funding as well as a super user for EPIC systems • Demonstrated knowledge of medical practice management systems and operate the Clinic’s • Very effective oral and written communication skills sufficient to make presentations; train others in billing processes and documentation and to interface effectively with staff to facilitate the flow of information between departments and external • Develop and run custom reports and create pivot tables and distribute to staff with deadlines for accounts to be corrected, resubmitted, voided and or posted• Ability to prioritize and perform a variety of tasks in a fast pace environment• Responsible for maximizing cash collections and maintaining the aging report under control by reviewing and assigning appropriate staff• Review and monitor all payment postings • Responsible for open encounters and determine why not processed and develop a plan for completion and submission by training providers and nursing staff• Work closely with all management leaders as well as external contractual accounts representatives to agree on settlement of payment and contract renewals• Ability to take initiative, function with a high level of independence and problem solve

• Responsible for auditing monthly a total of seven programs, including all aspects of accounting, medical billing and collections and especially documentation/progress notes• Practice and train staff in all HIPAA compliance regulations and all other company policy changes• Regularly meet predetermined goals for the Quality department• Update, maintain and submit reporting on all audit findings to the Executive Cabinet Team as well as preparing a corrective plan• Responsible for the training of all the staff on new policies, changes and state mandated procedures• Work very closely with the IT department in the development of EMR and exporting reports• Assist in coordination with team building retreats for each department, participate in the development of increasing employee morale• Utilize our Quality Improvement standard in meeting 95.5% of productivity, billing and collections• Knowledgeable about insurance company, medi-cal, and third parties for billing audits and payment• Collaborate with the other department management team to ensure the agency continues providing excellent customer service, trainings, and team building skills to assist and support the youth, families and the staff

• Implement all day to day functions of all physicians into a daily report• Conduct all verification of eligibility and process all medi-cal reservations• Implement policies and procedures on all state mandated updates and finance functions• Manage and audit all accounts receivable, apply, and allocate payment• Enter all billing electronically using IPCS (Internet Professional Claim Submission) system and other health insurance billing systems• Review, audit, and analyze all billing claims, line by line to ensure accurate submission• Post and record all receivables and cash payments and allocate to patient’s accounts• Complete successful payment collection form aging reports• Generate encounter bills and invoices for patients and mail out statements• Prepare daily, weekly, monthly, and quarterly reports including balance sheets and financial statements. • Audit procedure and diagnostic codes to ensure proper billing and allowance • Perform data entry, customer services, registration, and assist with patient accounts needs• Prepare manual CMS manual claims for private insurances• Audit all internal bookkeeping and patient charting• File disputes, grievances, and work all EOB’s denials to make proper collections • Developed an electronic medical record and billing system to utilize for most claims process• Prepare monthly and quarterly budget reports for Management• Maintain communication with third parties to assure payment collections• Perform IT hardware and office equipment functions

• Perform and monitor the performance of all Business office operations• Supervise functions and operations of entire IPA in the absence of the Administrator• Perform and manage medical records functions, front desk, registration, and consumer relations• Review and code encounter bills with appropriate ICD-9 diagnostics and RVS codes• Responsible for the collections of private pay and on site payments• Post cash/payment received from private pay and third party payments• Perform technical and analytical job functions to support all requirements of each department• Perform all recruitment, interviews, hiring, new hire orientation, and training new staff• Prepare daily deposits for routing and prepare ledger report using medical management• Communicate with other center departments and facilities by consulting and collaborating with management and address issues or concerns• Maintain up to date knowledge of all state mandated changes for billing and claim process by attending several external trainings as well as web-seminars and train staff and supervisors• Conduct weekly chart audits and randomly selecting 20 charts monthly for audit• Participate and educate staff in all safety programs including emergency response• Participate and evaluate in hazardous waste and infection control assignments as required • Meet weekly with the Pharmacy management to ensure contract and development goals were met• Held weekly staff meetings for updates on policy and procedures including daily tasks• Conduct weekly trainings to entire clinic staff of over 100 employees• Prepared schedule and monitor staff’s attendances including other facilities• Manage a department of nineteen staff, review, and approve time cards for payroll

• Manage the DMH accounts receivable and billing department• Conduct monthly chart audits of entire active roster and weekly on discharged charts• Review and post daily population statistics for the controller and CFO• Prepare monthly billing charges, receivables, and allowances for month end financials• Liaison with our external contract pharmacy in negotiating contracts and policies• Resolve all underpayments and denials and responsible for all collections accounts• Consolidate all outpatient and medication accounts• Assist in resources with admissions and outreach by liaison with DCFS, PO, and other agencies• Assist clinical staff in maximizing their billable minutes by ensuring support in documentation• Attend all necessary trainings and meetings outside facility including air travel to Sacramento• Develop written policies and procedures and provide feedback and support• Review and approve all accounts payable check request that fell under our DMH contract including travel/mileage expense, consulting expense, office supplies• Assist in budgets and contracts including line items such as salaries and vacant positions• Assist in planning and development by preparing statistics of clients and billable• Member of the Data Management committee in-house to develop an electronic billing system to centralize all entities (four facilities)• Part of the Los Angeles County Department of Mental Health Data Management committee in the implementation and testing of the new billing system from MIS to the IS system• Work very closely with the IT department in the implantation of billing application/system• Manage a department of eight staff, review, process time cards for payroll, prepare work scheduling and monitor attendance