License and Billing Manager

Job Description

Job Description

About Us:

SCADP

Southern California Alcohol and Drug Programs, Inc. (SCADP) was established in 1972 in a grassroots effort by community members seeking alternatives to prison for individuals with substance use disorder (SUD). SCADP is now a 501(c)(3) non-profit organization providing residential treatment services and outpatient counseling services to individuals throughout Los Angeles, as well as housing and supportive services for survivors of domestic violence. SCADP now offers services with a continuum of care to underserved and disadvantaged populations throughout the Los Angeles area.

PAY RATE: $66,500 - $70,000 Per Year

BENEFITS: SCADP offers competitive medical, dental, vision and retirement benefits.

JOB SUMMARY AND PURPOSE

While maintaining patient confidentiality and information security, the Licensing and Billing Manager will coordinate, supervise, and mentor the Drug Medi-Cal billers for SCADP/VOALA sites, oversees all billing procedures for Drug Medical programs, related staffs and dedicated billers. Conducts regular audits to ensure billing accuracy, and corrects errors, ensures required monthly billing to funder.

DUTIES AND RESPONSIBILITIES

Billing

• Monitor all intake billing related documentation in SAGE: CalOms, Financial Eligibility, Treatment Authorization, ICD 10 codes, Client Consent, and Clinical contact information
• Monitor timely completion and data entry of treatment notes to ensure accurate billing claims
• Monitor essential treatment note information (i.e. units of services, time start and end time)
• Daily, weekly, and monthly review and data entry of billable services
• Develops, records, and distributes monthly reports, and/or general information as needed
• Generates activity reports in SAGE and submit to Program Manager or designee
• Monitor and review denied claims and resubmit treatment services once corrected
• Maintain and store all billing supportive documentation as required by State guidelines
• Supervises staff (billers and DMC Verifiers) involved in billing for each of the SCADP and VOALA programs.
• Supervises billers to ensure proper billing procedures.
• Runs regular progress reports, and other reports as required by Medical senior staff and accounting.
• Monitors billing rejections from funder to ensure billers correct in appropriate manner.
• Other duties as required to meet program goals, subject to change as needed

Licensing

• Review documentation related to DHCS & DMC applications, collaborate with Clinical Regional Director to complete applications, submit, monitor processing, respond to additional documents requested
• Monitor and maintain records of required supporting documentation for renewal processes
• Communicate with DHCS licensing division and DMC certifying division regarding licensing and certification applications
• Maintain record of applications processed, application monitoring reports, deficiencies reported
• Development of corrective action plans related to application deficiencies
• Support Programs prior to and after audit review. Provide required supporting documentation for licensing audit purposes, review deficiencies report, develop corrective action plans, submit for approval
• Maintain DHCS licensing and DMC certification supporting documentation records

Other Duties

• Ensures adherence to staff licensure requirements. Monitors staff credentials regularly provides Managers credentialing expiration date reminders, collects and records required documentation. Collaborates with HR via credentialing report to provide updates on expired or expiring items. Uploads credentials and code of conduct to UltiPro system.
• Ensures adherence to provider staff TB, CPR, and first aid training requirements. Monitors staff documents, regularly provides managers expiration date reminders, collects and records required documentation. Uploads TB documents to UltiPro.
• Serves as Los Angeles County SAPC Sage EHR liaison. Collects and reviews required supporting documentation for County EHR system access for all users across SCADP & VOALA.
• Annually reviews, confirms, updates EHR user lists on record with SAPC
• Develop, maintain, and update agency standard census report. Annually collect and keep record of census. Update new fiscal year tab and issue report to Program Managers. Provide Clinical Regional Director census reports upon request.
• Serves as NACA (NACT) state reporting system liaison. On a monthly basis, collect data from Program Managers, reviews, updates, and ensure adherence to reporting requirements
• Serves as DATAR state reporting liaison. Responsible for granting or terminating access to system users. Collect monthly reports, keep reports on record.
• Collaborate with Recruiter on-site, provides updated credentialing and other documentation requirements as set by SAPC or DHCS
• Responsible for maintaining Standard Client File Master file. In collaboration with the Clinical Regional Director updates required State and County forms, provides Program Managers revised, new, or updated documents/ forms
• Responsible for maintaining Policies and Procedures Master file. In collaboration with the Clinical Regional Director reviews, updates required State and County policies and procedures as well as forms, provides Program Managers revised master file for audit purposes and forms required to be maintained/posted on site
• Update/ revise site layout, provide during County/ State review and provide sites updated copies
• Update/ revise site Organizational Charts, provide during County/ State review and provide sites updated copies
• Submit work orders for Administrative Offices located at the SCADP corporate office
• Maintains records of Iron Mountain inventory. Assists programs place orders to send or
• retrieve records. As required place service requests.

Compliance

• Keeps Clinical Regional Director and Quality Assurance Manager informed on progress or challenges with Clinical Documentation
• Collaborate with Clinical Regional Director in development of training tools for provider staff related to program procedures, documentation requirements, and State and County program requirements
• Technical assistance to Program Managers and staff for reporting annual training required in UltiPro
• Provides Program Manager and staff technical assistance managing EHR system related processes/ procedures for maintaining compliance with state and county standards.
• Collaborate with Clinical Regional Director to develop EHR workflow and step-by-step instruction guides

Contracts

• Keeps records of active SAPC contracts, updates, terminations, documentation related to contracts
• Collaborate with Clinical Regional Director to request contract amendments, update contract forms, submit required documents, report program changes
• Support Programs prior to and after audit review. Responsible for review of required supporting documentation for contract audit purposes, review deficiencies report, develop corrective ac??on plans, submit for approval
• Collaboration with Clinical Regional Director to provide Program Managers updated contractual agreement requirements and provide required forms/ documents
• Collaboration with Clinical Regional Director to revise/submit SBAT requests to LA County SAPC

Additional Duties

• Attends LA County SAPC meetings focused on billing requirements/ issues, training on service provision, quality assurance/compliance, contract requirements, DHCS licensing training, DMC PAVE system training, and annual internal training

MANDATED REPORTER

As service providers to the underprivileged and vulnerable in our community, all employees are considered Mandated Reporters, and must report any instance of physical or sexual abuse to proper authorities.

Qualifications

REQUIREMENTS:

• Must be able to pass a fingerprint clearance, background check, including criminal history, personal references, employment and education verifications
• Ability to perform under circumstances of possible emotional stress and conflicts dealing with difficult, uncooperative, and potentially aggressive clients as SCADP serves the neediest of the needy in our programs which may include clients with homelessness, mental-illness, substance abuse, recently released from incarceration and other challenges.

EDUCATION:

• High School or GED with strong math skills

EXPERIENCE:

• 1-year experience with Medi-Cal billing and/or data entry experience

PREFERRED QUALIFICATIONS:

• Associate Degree or medical coding certificate
• Familiar with SAGE billing/database

Southern California Alcohol and Drug Programs, Inc. (SCADP) is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.

This employer participates in E-Verify as required by the federal government and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

If E-Verify cannot confirm that you are authorized to work, this employer is required to give you written instructions and an opportunity to contact Department of Homeland Security (DHS) or Social Security Administration (SSA) so you can begin to resolve the issue before the employer can take any action against you, including terminating your employment.