Why work for us?
- Balboa Nephrology is the largest kidney care practice in California and participates in a national Medicare program focused on value-based care.
- Through our joint venture with Evergreen Nephrology we are a growing organization with opportunities for professional and personal growth.
- We will help you grow in your leadership experiences while learning the new value-based care world.
- Comprehensive benefits package that includes medical, dental & vision on the 1st of the month 30 days after hire.
- Employer contribution of up to 7.5% of annual pay for your 401K.
- Generous paid time off plus 8 paid holidays!
- Company paid life insurance.
- Join a fast-growing field - employment of medical and health services managers is projected to grow 32 percent from 2020 to 2030, much faster than the average for all occupations.
- Voted 4 years in a row as a Top Workplace of San Diego 2020-2024!
Our Values: Patient-centered I Accountability I Respect I Innovation I Data-Driven
Our Mission: Igniting hope and healing for people with kidney disease through compassionate, innovative care.
Work Location: Hybrid
- Works out of our Hazard Way office in San Diego, CA.
- Eligible for hybrid schedule upon successful completion of onboarding/training. Position is usually in office 2-3 days a week, based on business needs.
- Employee must reside within San Diego County, California.
Position Summary:
This role will have primary responsibility to supervise the claims submission process, ensuring clean claims are properly and timely submitted following payor and internal guidelines.
The Supervisor is a working supervisor providing guidance and support to staff within revenue cycle assignment area which may include one or more areas (Eligibility and Authorizations, Claims, Payments and Credits, Accounts Receivable, Medical Records). The Supervisor directs staff in completing assignments using established guidelines, procedures, and policies. Recommends new and revised procedures as needed to improve patient care and key performance indicators.
Pay Range: $70,500 - $76,000/annually plus leadership bonus incentive based on performance
Essential Duties and Responsibilities:
- Leads and develops staff to achieve successful Key Performance indicators through guidance and support. Works day-to-day functions of staff as needed.
- Acts as a resource for staff operational questions. Remains abreast and researches payor policies and procedures, system issues and functions, and billing and collections requirements.
- Works in collaboration with other leaders to ensure proper coverage within revenue cycle functions.
- Trains new staff and provides ongoing training.
- Documents processes and updates to ensure standardized operating procedures are efficient, clear, meaningful, and easily accessible.
- Performs analysis, research, and audits to ensure informed and smooth operations to support key performance indicators.
- Presents findings and recommendations in a clear manner to support continual improvement.
- Promptly and accurately responds to billing inquiries from patients, payers, and internal customers.
- Continuously identifies issues and trends impacting quality and timely reimbursement and proposes potential solutions.
- Supports and actively participates in process improvement initiatives.
- Assists with other duties to support the revenue cycle process and Balboa’s core values as assigned.
Required Qualifications:
- Reside in San Diego County, California.
- 4 years recent and progressive professional medical billing/collection experience within a medical billing environment for a medical group/physician practice.
- Prior experience utilizing Epic for revenue cycle functions.
- Strong understanding of the entire revenue cycle process.
- Demonstrated knowledge of medical terminology, CPT, HCPCS, ICD-10 and modifier codes, including impact on coverage and reimbursement.
- Knowledge of collection processes and collection laws.
- Vast payor experience including Medicare, Medi-Cal, HMO, FFS, PPO and IPA’s.
- Strong people management skills with the ability to inspire, coach, develop, and hold teams accountable.
- Strong analytical and critical thinking skills, with ability to develop proposals.
- Strong proficiency with Microsoft Windows (ability to navigate, create and rename folders, save, and organize files), Strong proficiency with Microsoft Office products (Outlook, OneNote, Teams, Excel, Word), proficiency with Adobe PDF. Ability to type 30 words per minute.
Preferred Qualifications:
- Nephrology specific experience within revenue cycle.
- 5 or more years recent experience in professional claims.
- Recent experience utilizing specific areas within Epic for authorizations, claims edits, payments and credits, account receivable, and medical records.
- Prior, recent and relevant experience leading staff.
- CPC certification
Education:
- High School graduate required.
Required Skills:
- Ability to lead
- Excellent verbal and written communication.
- Ability to provide excellent customer service.
- Ability to interpret, adapt and apply guidelines and procedures.
- Ability to use good reasoning and judgement and react appropriately in emergency situations.
- Ability to establish and maintain effective working relationships with patients, medical staff, and coworkers.
- Ability to multitask and stay organized. Detail oriented and ability to prioritize work.
Other considerations:
- Background check required
- Travel to other sites located within San Diego County may be required
- Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
- Supervisory duties – Yes
This position is being handled internally. We are not accepting solicitations from external recruiters or staffing agencies at this time.
Language Skills
While performing duties, the employee is regularly required to talk, hear, read, write, type and respond in English and understand clinical/medical vocabulary written and spoken.
Vision Requirements
Vision requirements include close vision, ability to adjust focus, and see color.
Physical Demands
Physical requirements may vary slightly and should be reviewed with your manager. In general, this position requires the ability to lift up to 35 pounds unassisted; ability to stand for extended periods of time and to perform repetitive stooping, walking, stretching, reaching and some sitting; ability to use full range of body motions required to lift patients, wear a lead apron, and lift and move supplies. Must be able to safely ascend and descend stairs as a core part of the job, with or without reasonable accommodation, when no elevator or lift is present.
Work Environment
Job required tasks routinely involve a potential for mucous membrane or skin contact with blood, body fluids, tissues or potential spills or splashes. Use of appropriate personal protection measures is required for every healthcare provider in these positions. Require to routinely use standard office equipment such as laptop, computer, mouse, and photocopier.
About Balboa United
Beginning in 1973, Balboa has grown from two physicians to a comprehensive nephrology team of 52 board certified physicians and 8 advanced practitioners. On January 1, 2018, Balboa Nephrology Medical Group (BNMG) launched Balboa United, a full-service medical practice management services organization. From one small office, BNMG now has 24 clinical offices throughout San Diego, Imperial, Orange and Riverside counties. In addition to office and hospital-based patient care, Balboa physicians manage the dialysis treatments of approximately 4,500 patients at 88 dialysis centers and conduct Nephrology based clinical research at 6 centers throughout Imperial and San Diego counties (California Institute of Renal Research).
- EEO Statement Balboa United is an equal opportunity employer and makes employment decisions on the basis of merit. We want to have the best available person in every job. Our Company policy prohibits unlawful discrimination based on race, color, creed, religion (including religious dress & grooming), sex (including pregnancy, childbirth or related medical conditions), gender (including gender identity and gender expression), marital status, registered domestic partner status, military status, age, national origin or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), genetic information, sexual orientation, or any other basis protected by applicable federal, state, or local law. We also prohibit unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has or is perceived as having any of those characteristics. The Company is committed to compliance with all applicable laws providing equal employment opportunities. This commitment applies to all persons involved in our operations and prohibits unlawful discrimination by any employee of Balboa United, including managers and co-workers. If you believe you have been subjected to any form of unlawful discrimination, submit a written complaint to your manager or Human Resources (HR). Your complaint should be specific and should include the names of the individuals involved and the names of any witnesses. If you need assistance with your complaint, or if you prefer to make a complaint in person, contact the Company's Human Resources Department. We will immediately undertake an effective, thorough, and objective investigation and attempt to resolve the situation.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.
