San Francisco Department of Public Health
SENIOR BILLING MANAGER (0923 - Manager II)
San Francisco Department of Public Health, San Francisco, CA, United States
Recruitment: RTF0153347-01115573
Published: December 23, 2024
Contact:
Steven Scoles - steven.scoles@sfdph.org
Department: Public Health
Job class: 0923-Manager II
Starting salary range: $141,700.00 - $180,856.00 (Range A)
Role type: Permanent Civil Service
Hours: Full-time
Exam type: Position Based Test
Rule: Rule of the List
About:
The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in its workforce. All employees at the Department of Public Health work to advance equity, inclusion, and diversity with a specific lens and focus on race, ethnicity, gender, sex, sexuality, disability, and immigration status.
Application Opening: December 20, 2024
Application Deadline: Application filing will close on or after January 3, 2025
Salary: 0923 Manager II (Effective January 4, 2025, Range A Salary between $141,700 and $180,856)
Appointment Type: Permanent Civil Service
Recruitment ID: PBT-0923-153351
Role description
Under direction of the Deputy Director, Patient Financial Services & Patient Accounting, the 0923 Senior Billing Manager is responsible for the successful billing in revenue generated from the San Francisco Health Network, Population Health, and Behavioral Health Services for the department to realize $752 million in reimbursement annually. This position provides leadership for the billing teams across the department and analyzes billing regulations and provider updates related to Medicare, Medi-Cal, and other private, government, and city and county programs.
This position is also responsible for billing system updates and reports. This includes monthly revenue analysis by division, quarterly CMS credit balance reports for both hospitals, and yearly Federally Qualified Health Center (FQHC) reconciliation. This position is also the Server Patching Owner for Experian network upgrades and tests, requiring 24/7 availability during EPIC system patching windows.
Essential Duties:
The Senior Billing Manager (0923 Manager II) may perform other duties as assigned or required.
How to qualify
Required Minimum Qualifications:
Education: Possession of a bachelor's degree from an accredited college or university; AND
Experience: Four (4) years of experience in billing, claims processing, and/or collecting healthcare service reimbursements.
Education Substitution: Additional qualifying experience may substitute for the degree requirement on a year-for-year basis. One year (2,000 hours) of qualifying experience will be considered equivalent to 30 semester units/45 quarter units.
Note: One-year full-time employment is equivalent to 2,000 hours (2,000 hours of qualifying work experience is based on a 40-hour work week).
Applicants must meet the minimum qualification requirement by the final filing date unless otherwise noted.
DESIRABLE QUALIFICATIONS: The stated desirable qualifications may be considered at the end of the selection process when candidates are referred for hiring:
Two years of experience supervising staff performing billing, claims processing, or healthcare service reimbursements.
EPIC Resolute Hospital Billing Certificate and/or EPIC Resolute Professional Billing Certificate.
Important Note: Please make sure it is absolutely clear in your application exactly how you meet the minimum qualifications. Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. Please be aware that any misrepresentation of this information may disqualify you from this recruitment or future job opportunities.
Selection Procedures:
After application submission, candidates deemed qualified must complete all subsequent steps to advance in this selection process, which includes the following.
Supplemental Questionnaire (SQ) (Weight: 100%): Candidates who qualify will be invited to participate in a Supplemental Questionnaire (SQ) that is designed to measure the knowledge, skills, and abilities in job-related areas which may include but not be limited to: Knowledge of elements and individual payor requirements for medical billing such as UB-04, CMS-1500, 837I, 837P, and 277, knowledge of CMS FQHC reporting requirements, knowledge of donor organ billing, coding, and coordination processes, and knowledge of SNF/LTC billing and follow-up requirements.
The SQ will be emailed to the address listed on the candidate’s online application. Candidates will be required to respond to the SQ in the time frame indicated and must submit the completed questionnaire as directed in order to have it evaluated. Responses cannot be changed once submitted. Candidates will be evaluated based on their SQ responses.
Candidates must achieve a passing score in order to continue in the selection process. Candidates will be placed on the confidential eligible list/score report in rank order according to their final score.
Additional selection processes may be conducted by the hiring department prior to making final hiring decisions.
What else should I know?
Certification:
The certification rule for the eligible list resulting from this examination will be the Rule of the List.
Eligible List/Score Report:
Once you pass the exam, you will be placed onto an eligible list and given a score and a rank. For more information, visit https://careers.sf.gov/knowledge/process/
The duration of the eligible list resulting from this examination process will be 6 months and may be extended with the approval of the Human Resources Director.
How to apply:
Applications for City and County of San Francisco jobs are only accepted through an online process. Visit careers.sf.gov and begin the application process. #J-18808-Ljbffr
Published: December 23, 2024
Contact:
Steven Scoles - steven.scoles@sfdph.org
Department: Public Health
Job class: 0923-Manager II
Starting salary range: $141,700.00 - $180,856.00 (Range A)
Role type: Permanent Civil Service
Hours: Full-time
Exam type: Position Based Test
Rule: Rule of the List
About:
The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in its workforce. All employees at the Department of Public Health work to advance equity, inclusion, and diversity with a specific lens and focus on race, ethnicity, gender, sex, sexuality, disability, and immigration status.
Application Opening: December 20, 2024
Application Deadline: Application filing will close on or after January 3, 2025
Salary: 0923 Manager II (Effective January 4, 2025, Range A Salary between $141,700 and $180,856)
Appointment Type: Permanent Civil Service
Recruitment ID: PBT-0923-153351
Role description
Under direction of the Deputy Director, Patient Financial Services & Patient Accounting, the 0923 Senior Billing Manager is responsible for the successful billing in revenue generated from the San Francisco Health Network, Population Health, and Behavioral Health Services for the department to realize $752 million in reimbursement annually. This position provides leadership for the billing teams across the department and analyzes billing regulations and provider updates related to Medicare, Medi-Cal, and other private, government, and city and county programs.
This position is also responsible for billing system updates and reports. This includes monthly revenue analysis by division, quarterly CMS credit balance reports for both hospitals, and yearly Federally Qualified Health Center (FQHC) reconciliation. This position is also the Server Patching Owner for Experian network upgrades and tests, requiring 24/7 availability during EPIC system patching windows.
Essential Duties:
- Manages patient accounting staff, including patient accounts managers, supervisors, and billing staff.
- Resolves all EPIC billing claim edits across all hospitals and divisions.
- Monitors, interprets, and implements billing regulations and provider updates related to Medicare, Medi-Cal, and other private, government, and city and county programs.
- Prepares monthly revenue analysis by division, related to claims submission volume and trends based on claim/error type and/or payer, including outstanding unbilled revenue.
- Develops, interprets, coordinates, and enforces policies and procedures specific to each division's revenue.
- Prepares quarterly CMS credit balance reports for all DPH Zuckerberg San Francisco General (ZSFG) and Laguna Honda Hospital & Rehabilitation Center (LHH) Medicare Provider Transaction Access Numbers (PTANS), attesting to accuracy in submission of certification and ensuring credit balance corrections are completed in accordance with CMS 835 instructions.
- Prepares, submits, and certifies yearly Federally Qualified Health Center (FQHC) reconciliation for 19 DPH/CCSF FQHC clinics, including ensuring all valid visits and differential rate claims are properly billed and reimbursed by all payors and all undistributed payments are properly aligned with valid visits within the timeline for reporting to California Department of Health Care Services (DHCS).
- Oversees all billing, follow-up, and collections within LHH to successful adjudication of all gross revenue in accordance with Skilled Nursing Facility/Long Term Care (SNF/LTC) and Laguna Honda Hospital specific guidelines.
- Creates Hospital Account Records (HARs) for all organ donor accounts involving Donor Network West, including interpreting medical chart to determine Donor Network responsibility and splitting gross revenue between Donor Network West and private insurance, and ensuring coding accuracy to avoid inappropriate billing.
- Acts as the Server Patching Owner for Experian network upgrades and tests, available 24/7 during patching windows.
The Senior Billing Manager (0923 Manager II) may perform other duties as assigned or required.
How to qualify
Required Minimum Qualifications:
Education: Possession of a bachelor's degree from an accredited college or university; AND
Experience: Four (4) years of experience in billing, claims processing, and/or collecting healthcare service reimbursements.
Education Substitution: Additional qualifying experience may substitute for the degree requirement on a year-for-year basis. One year (2,000 hours) of qualifying experience will be considered equivalent to 30 semester units/45 quarter units.
Note: One-year full-time employment is equivalent to 2,000 hours (2,000 hours of qualifying work experience is based on a 40-hour work week).
Applicants must meet the minimum qualification requirement by the final filing date unless otherwise noted.
DESIRABLE QUALIFICATIONS: The stated desirable qualifications may be considered at the end of the selection process when candidates are referred for hiring:
Two years of experience supervising staff performing billing, claims processing, or healthcare service reimbursements.
EPIC Resolute Hospital Billing Certificate and/or EPIC Resolute Professional Billing Certificate.
Important Note: Please make sure it is absolutely clear in your application exactly how you meet the minimum qualifications. Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. Please be aware that any misrepresentation of this information may disqualify you from this recruitment or future job opportunities.
Selection Procedures:
After application submission, candidates deemed qualified must complete all subsequent steps to advance in this selection process, which includes the following.
Supplemental Questionnaire (SQ) (Weight: 100%): Candidates who qualify will be invited to participate in a Supplemental Questionnaire (SQ) that is designed to measure the knowledge, skills, and abilities in job-related areas which may include but not be limited to: Knowledge of elements and individual payor requirements for medical billing such as UB-04, CMS-1500, 837I, 837P, and 277, knowledge of CMS FQHC reporting requirements, knowledge of donor organ billing, coding, and coordination processes, and knowledge of SNF/LTC billing and follow-up requirements.
The SQ will be emailed to the address listed on the candidate’s online application. Candidates will be required to respond to the SQ in the time frame indicated and must submit the completed questionnaire as directed in order to have it evaluated. Responses cannot be changed once submitted. Candidates will be evaluated based on their SQ responses.
Candidates must achieve a passing score in order to continue in the selection process. Candidates will be placed on the confidential eligible list/score report in rank order according to their final score.
Additional selection processes may be conducted by the hiring department prior to making final hiring decisions.
What else should I know?
Certification:
The certification rule for the eligible list resulting from this examination will be the Rule of the List.
Eligible List/Score Report:
Once you pass the exam, you will be placed onto an eligible list and given a score and a rank. For more information, visit https://careers.sf.gov/knowledge/process/
The duration of the eligible list resulting from this examination process will be 6 months and may be extended with the approval of the Human Resources Director.
How to apply:
Applications for City and County of San Francisco jobs are only accepted through an online process. Visit careers.sf.gov and begin the application process. #J-18808-Ljbffr