Refunds Manager Jobs in Riverside, CA (NOW HIRING)

Position Summary

Brault is a practice management, billing and coding company exclusively serving acute care independent physician practices. A high volume privately held and family-owned medical billing company, we are currently looking for an energetic, experienced and service driven Client Manager. The Client Manager works with the Officers of the Company and other Management to provide the highest level of service possible to each Client. The Client Manager works with their Service Teams to maximize their productivity and accuracy in processing and pursuing Client account follow-up to optimize collections per visit. The Client Manager seeks to thoroughly research and understand Client billing needs/issues and communicate them to fellow Management and Staff. The Client Manager will interact proactively and positively with all Clients and Staff establishing professional partnerships, teamwork and cooperation. The Client Manager supports the Company Mission Statement and is responsible for meeting or exceeding Client Targets, Compliance Standards and Contractual Requirements.

Essential Duties and Responsibilities

1. Support the Company Mission Statement and contribute to the development of a positive culture through personal example, contributions to assigned committees, and daily interactions with other Staff.
2. Comprehend and support Compliance Policies and Protocols outlined in the Compliance Manual by:
3. Reviewing new situations for Clients for possible compliance issues;
4. Facilitating escheat and refund processes for Clients as appropriate;
5. Monitoring third party payer denials for possible Compliance problems;
6. Monitoring Client monthend reports for unexplained fluctuations in average patient charge, acuity, erroneous physician billing.
7. Assisting Billing Systems with appropriate master file entry of physicians.
8. Appropriately notify the Compliance Officer of potential compliance problems or violations.
9. Work closely with the Officers of the Company to effectively manage the Clients’ business and practices to optimize collections per visit and achieve established Client Targets by:
10. Coordinating analyses of key performance data and providing feedback as appropriate to Clients;
11. Provide monthly written analysis of month end key metrics with action plans as needed;
12. Provide timely, thoroughly reviewed responses to Client issues or questions including patient complaints;
13. Facilitating Client Set-up (as appropriate); Demonstrating full knowledge of Clients’ contracts and hospital relationships; Managing the Accounts Receivable Follow-up Processes to optimize C.P.V.;
14. Investigating Third Party Payor issues/trends and notifying/documenting problems for Officers, Clients, and Staff; Closely monitoring daily and weekly claims processing; provide solutions;
15. Ensuring the timely resolution of referred Patient Complaints;
16. Work in a positive manner to provide knowledgeable, accurate information and documentation to other Departments to improve services to Clients including:
17. Demonstrate knowledge of On-Site and/or Data Control issues and offer solutions;
18. Understand and communicate Client requests regarding Patient messaging and scripting for Patient Services; maintain up-to-date Contract Summary Forms;
19. Review and track Provider Enrollment holds and denials
20. Provide guidance and approvals on complex, non-standard refunds;
21. Accumulate data, track errors, and interpret results to guide and assist Operations to improve and standardize processes;
22. Work effectively with subordinates to increase their knowledge base and skills, to train them to analyze/resolve problems, and to create a stronger sense of teamwork and Client service;
23. Assisting Coders and Provider Enrollment in identifying new physicians and completion of enrollment processes; Work with individual team members to assess, track and improve their productivity and accuracy, to provide skills training and fully orient staff in all aspects of billing (as appropriate), and to perform individual reviews annually within 60 to 90 days of due date (or as necessary to address performance issues) to achieve Team, Client and Company goals
24. Maintain services and costs within established budgets and report on/initiate actions to address problems or variances.
25. Review and understand the following Departments and/or organizational functions:
26. Accounts Receivable Management;
27. Payment Posting;
28. Claims Processing;
29. Designated Systems Functions.
30. Perform other duties as assigned for Practice Management Clients
31. Assist with benefits administration, payroll changes, scheduling changes, staffing and meeting administration.
32. Perform other duties as assigned to achieve Company goals.

Knowledge, Skills, and Abilities

• Advanced knowledge of MS Word and Excel
• Advanced knowledge of MS Teams
• Advanced analytical and problem-solving skills
• Knowledge of medical billing: denials, appeals, secondary billing and refunds.
• Ability to multi-task, organized and detail oriented.
• Ability to meet/exceed goals and build relationships
• Strong customer focus with ability to resolve Client or patient disputes.

Education and Experience

• Bachelor’s degree preferred in related field
• Experience in an accounts receivable environment.
• Basic knowledge of payment posting and accounting.
• Proficient in billing system (does not include reports); Athena preferred.
• Experience in sales, business, or management preferred