This is a remote position.
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.
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.