Lead Revenue Specialist

Location

Camarillo, CA | United States

Job description

Job Details

Job Location

Campus - Camarillo, CA

Position Type

Full Time

Education Level

Associates

Salary Range

$25.00 - $38.00 Hourly

Job Shift

Day

Job Category

Finance

Wage band range $25.00 - $38.00 per hour; however, starting pay is ultimately determined by the scope of the position, the candidate's relevant experience, and internal equity.

Carries out the mission of Casa Pacifica as it pertains to managing the revenue and accounts receivable, and administrative support to the programs.  Works in a team environment under the direction of the Accounting Manager.  The Lead Revenue Specialist – Private Insurance is responsible for ensuring that strong revenue recognition principles, practices and procedures are implemented and maintained.

DUTIES AND RESPONSIBILITIES:

• Supervise the integration and effective use of billing software and Electronic Health Record (EHR) systems, aiming to optimize workflows and enhance precision in operations.
• Oversee the entire revenue cycle process, including private insurance verification, coding, billing, and collections.
• Develop and implement strategies to optimize revenue, minimize denials, and accelerate reimbursement processes.
• Ensure accurate and compliant coding practices for medical procedures and diagnoses.
• Review and process insurance claims, resolving discrepancies or issues to facilitate timely payments.
• Serve as the primary contact for private insurance companies, managing contracts, negotiations, and resolving payment disputes.
• Stay updated with changes in insurance policies, regulations, and billing requirements to ensure compliance.
• Analyze revenue data and generate reports to evaluate revenue cycle performance.
• Provide insights and recommendations for improving revenue generation and collection efficiency.
• Ensure compliance with healthcare regulations (HIPAA, Stark Law) and insurance industry standards.
• Review documentation for accuracy, completeness, and compliance with coding and billing guidelines.
• Providing guidance, training, and support to team members to ensure high-quality work and goal attainment.
• Foster a collaborative and knowledgeable team environment focused on efficiency and accuracy.
• Collaborate closely with Accounting Manager to facilitate revenue analysis and support audit processes, ensuring comprehensive coordination and alignment across the department.
• Work on special projects as assigned.

EDUCATION and/or EXPERIENCE: Associate degree in Business or Finance or related field or equivalent experience in accounting environment. Two to four years of experience and in-depth knowledge of healthcare billing, coding, and reimbursement processes.

LANGUAGE SKILLS: Ability to read and interpret documents such as insurance requirements, authorizations, and coverages, safety rules, operating and maintenance instructions, and procedure manuals.  Ability to write routine reports and correspondence.

COMMUNICATION SKILLS: Ability to respond to inquiries from internal and external stakeholders and third-party payers. Ability to write reports and business correspondence and procedure manuals. Ability to effectively present information and respond to questions from groups of managers.

ANALYTICAL SKILLS: Strong analytical and problem-solving skills to identify and address billing issues promptly.  Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to work with and apply mathematical concepts.

ATTENTION TO DETAIL:  Meticulous attention to detail to ensure accuracy in billing and coding.

OTHER SKILLS AND ABILITIES:  

• Advanced level Microsoft Excel expertise required.
• Proficiency in medical billing software and Electronic Health Record (EHR) systems.
• Experience in REV Connect is highly desirable.
• Ability to work with financial systems.
• Ability to effectively present information and respond to questions from groups of managers.
• Knowledge of healthcare billing processes, coding systems, and regulatory requirements and familiarity with insurance claim processing and reimbursement methodologies

Casa Pacifica offers:

• Comprehensive benefits package, including 401k with up to 5% fully vested employer matching contributions made after first year of service
• Medical, Dental & Vision Insurance options
• Flexible spending and dependent care programs
• Excellent training opportunities
• Education/tuition assistance programs
• Group Discount Pet Insurance
• Aflac Critical Illness, Accidental & Dental supplemental plan options
• Employee Assistance Program
  • Free Confidential Crisis Line 24/7 (365 days a year)
  • Four face to face or telephonic sessions per issue, i.e.,
    • Stress, Anxiety, Depression
    • Life transitions
    • Grief and Loss
    • Divorce
    • Conflict Resolution
    • Substance Abuse
    • Work-Life Counseling
    • Free Legal and Financial consultations
    • Identity Theft Recovery Services

Casa Pacifica restores hope, enhances resilience, and strengthens community connections for children, young adults, and families.

We are a diverse and inclusive team providing excellent services to all our communities. Our team members are empowered to share their identities, ideas, and perspectives. A culture built on diversity, equity and inclusivity is essential to creating a safe and healing environment at Casa Pacifica.

Casa Pacifica is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. All applicants will be given full consideration under state, local, and federal law.

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