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CodeMax Behavioral Health Billing · 3 months ago

Account Manager (Substance Abuse Billing)

Los Angeles, CA

Full-time

Onsite

Mid Level

3+ years exp

CodeMax Behavioral Health Billing is a company focused on providing billing solutions in the mental health and substance abuse domain. The Account Manager will oversee billing operations, ensure compliance with regulations, and address customer inquiries while managing medical records and staff training.

BillingHealth CareOperating Systems

Responsibilities

Oversees the management and organization of SA and MH medical records

Familiarity with ASAM, LOCUS, and MCG criteria to review and assess the appropriateness of treatments and recommendations

Ensures the confidentiality of patient information in compliance with HIPAA and other relevant guidelines

Trains and guides clinical staff on proper record-keeping for all of the Departments (VOB,UR, BILLING etc...)

Using their extensive knowledge and experience with Substance Abuse billing science and technology, resolves discrepancies or issues in patient records and makes corrections exercising sound independent judgment and making impactful decisions grounded in lessons learned/education gained

Monitors and ensures staff compliance with the latest SA and MH regulations

Generates and reviews reports related to patient care, interventions, and compliance

Generates and reviews operational metrics understanding and acting upon trends, bottlenecks and anomalies

Anticipates adverse customer impacts and proactively communicates with Customers as well as driving and communicating resolutions

As a point of escalations, follows up on unpaid claims and manages denials by conducting investigations and assisting with filing appeals

Participates in management meetings, offering insights, and updates related to SA and MH Claims, billing, posting, utilization review, vob and medical records

Documents medical billing procedures and trains staff as necessary

Resolves patient and customer inquiries and complaints related to medical billing

Provides training and guidance to peers and operational staff as required

Stays updated with the latest trends, research, and regulations in SA and MH care and record-keeping

Other duties assigned by the department supervisor and/or management team

Qualification

Substance Abuse billingASAMLOCUSMCG criteriaElectronic Health Records (EHR)Data managementLeadership abilitiesProblem-solving skillsCustomer service skillsAnalytical thinkingOrganizational skillsCommunication skills