Patient Accounting Manager

Contra Costa Health is offering an excellent opportunity for two (2) Patient Accounting Managers within Contra Costa Health Plan (CCHP). CCHP is a federally qualified state-licensed and county-sponsored Health Maintenance Organization (HMO) serving Contra Costa County in the East Bay of the San Francisco Bay Area. Established in 1973 CCHP was the first county-sponsored HMO in the United States and today serves as the largest managed care health plan in Contra Costa County covering more than 250000 residents.

CCHP is committed to providing equitable accessible and high-quality healthcare to our culturally and linguistically diverse members. Within CCHP the Patient Accounting Manager will serve as the manager of the CCHP Claims Department overseeing claims operations to ensure accurate and timely processing compliance with Medi-Cal Medicare and commercial payer requirements and alignment with the plans mission of supporting member and provider needs.

Contra Costa Health Services (CCHS) the broader health system in which CCHP is housed is the largest department in Contra Costa County with more than 4000 employees providing integrated healthcare services and serving as the safety net for low-income and uninsured residents.

• Experienced in Managed Care: Brings direct experience in health plan claims operations within a managed care environment
• Knowledgeable in Medicaid and Medicare: Understands Medi-Cal and Medicare program requirements including billing payment and compliance
• A Strong Communicator: Able to clearly explain complex billing and claims issues to staff providers and leadership
• Solution-Oriented: Approaches challenges with a positive attitude and a commitment to continuous improvement
• Professional and Collaborative: Excels at working in a team environment while maintaining accountability
• Discreet and Judicious: Exercises good judgment in handling confidential and sensitive matters
• Supportive: Invests in the training coaching and professional development of staff

• Managing and supervising claims operations for CCHP including claims processing adjustments and payment integrity
• Selecting training evaluating and monitoring the performance of subordinate personnel including supervisors and clerical staff
• Overseeing workflows to ensure timely and accurate adjudication of claims across Medi-Cal Medicare and commercial lines of business
• Serving as liaison with providers county healthcare staff and external stakeholders to resolve claims-related issues
• Ensuring compliance with federal state and local regulations as well as managed care Medi-Cal and Medicare standards
• Monitoring claims performance metrics including timeliness accuracy and compliance with DHCS (Department of Health Care Services) DMHC (Department of Managed Health Care) requirements and CMS (Center for Medicare and Medicaid Services)
• Reporting key claims issues trends and operational updates to higher management in a timely manner
• Collaborating with Finance Utilization Management Compliance and other divisions to align claims operations with organizational goals

• You will have a direct role in ensuring providers are paid accurately and members claims are handled efficiently
• You will work in a dynamic environment with dedicated professionals focused on operational excellence and equity
• You will help support CCHPs mission of providing high-quality healthcare to the countys most vulnerable populations
• You will be part of a collaborative experienced finance and claims team with well-defined processes
• We offer generous benefits and a competitive retirement package

• Adapting to constantly evolving federal state Medi-Cal and Medicare claims regulations
• Managing multiple competing deadlines in a high-volume claims environment
• Providing clear and effective communication when conflicts or discrepancies arise
• Maintaining deep knowledge of complex billing and payment requirements across Medicaid Medicare and commercial insurance lines

• Delivering Results: Meeting organizational goals and customer expectations through accurate timely claims processing
• Legal & Regulatory Navigation: Understanding interpreting and ensuring compliance with laws and regulations
• Ownership & Accountability: Holding self and others accountable for high-quality efficient results
• Handling Stress: Maintaining stability and composure under pressure or competing demands
• Oral Communication: Clearly explaining issues decisions and solutions to diverse stakeholders
• Interpersonal Savvy: Building relationships and responding appropriately to the needs of others
• Leadership: Guiding training and motivating staff to achieve departmental and organizational goals

Education: Possession of a Bachelors degree from an accredited college or university with a major in business administration finance accounting health care administration or a closely related field.

Experience: Three (3) years of full-time or its equivalent experience in an administrative managerial or supervisory position with direct responsibility for delivery of patient business services patient accounting services insurance billing services collection services or patient financial counseling services in a health care services organization.

Substitution for Education:

1. Possession of an Associates Degree or successful completion of sixty (60) semester or ninety (90) quarter units from an accredited college or university combined with two (2) years of full-time additional qualifying experience may be substituted for the required Bachelors degree; OR
2. Possession and maintenance of one of the following professional certifications: Certified Healthcare Financial Professional (CHFP) issued by the Healthcare Finance Management Association (HFMA) or Certified Patient Account Manager (CPAM) or Certified Clinic Account Manager (CCAM) certifications issued by the American Association Of Healthcare Administrative Management (AAHAM); or Certified Patient Account Technician (CPAT) or Certified Clinic Account Technician (CCAT) combined with additional four (4) years of full-time qualifying experience may be substituted for the required Bachelors degree.

Substitution for Experience and Education: Five (5) years of full-time or its equivalent experience as an Account Clerk Supervisor in Contra Costa County may be substituted for the required education and experience.

1. Application Filing and Evaluation: Applicants will be required to complete a supplemental questionnaire at the time of application applications will be evaluated to determine which candidates will move forward in the next phase of the recruitment process.
2. Remote Oral Assessment: Candidates who possess the minimum qualifications will be invited to participate in an online oral assessment. The assessment will measure candidates competencies as they relate to the the assessment candidates must achieve an average passing score of 70% or higher on each of the competencies as well as an overall passing score of 70% or higher. These may include but are not limited to: Delivering Results Legal & Regulatory Navigation Displaying Ownership and Accountability Handling Stress Oral Communication Oral Communication Interpersonal Savvy and Leadership. (Weighted 100%)