Account Manager (Substance Abuse Billing)

DEPARTMENT: Account Management Department

REPORTS TO: Manager, Account Management

EMPLOYMENT STATUS: Full-Time

FLSA STATUS: Exempt

LOCATION: Van Nuys, CA - ONSITE

Job Summary:

The Account Manager is a highly motivated and detail-oriented individual. They possess a strong understanding of medical billing procedures, coding, insurance claims, and excellent customer service skills. This position will be responsible for ensuring accurate and efficient billing operations as well as working with customers/facilities to both proactively and reactively address billing issues. Below are the job duties and responsibilities outlined, however, the job duties are not limited to the items listed.

Duties/Responsibilities:

• Oversees the management and organization of SA and MH medical records
• Familiarity with ASAM, LOCUS, and MCG criteria to review and assess the appropriateness of treatments and recommendations.
• Ensures the confidentiality of patient information in compliance with HIPAA and other relevant guidelines.
• Trains and guides clinical staff on proper record-keeping for all of the Departments (VOB,UR, BILLING etc...)
• Using their extensive knowledge and experience with Substance Abuse billing science and technology, resolves discrepancies or issues in patient records and makes corrections exercising sound independent judgment and making impactful decisions grounded in lessons learned/education gained.
• Monitors and ensures staff compliance with the latest SA and MH regulations
• Generates and reviews reports related to patient care, interventions, and compliance
• Generates and reviews operational metrics understanding and acting upon trends, bottlenecks and anomalies
• Anticipates adverse customer impacts and proactively communicates with Customers as well as driving and communicating resolutions
• As a point of escalations, follows up on unpaid claims and manages denials by conducting investigations and assisting with filing appeals
• Participates in management meetings, offering insights, and updates related to SA and MH Claims, billing, posting, utilization review, vob and medical records
• Documents medical billing procedures and trains staff as necessary
• Resolves patient and customer inquiries and complaints related to medical billing
• Provides training and guidance to peers and operational staff as required
• Stays updated with the latest trends, research, and regulations in SA and MH care and record-keeping
• Other duties assigned by the department supervisor and/or management team
  
  

Required Skills/Abilities:

• Strong leadership and managerial abilities
• Excellent organizational skills and attention to detail
• Superior problem-solving abilities and analytical thinking
• Outstanding written and verbal communication skills
• Proficiency in data management, data entry, and basic office software applications
• Strong issue resolution and customer/patient de-escalation skills
• The successful candidate will possess a deep understanding of SA and MH medical records, be familiar with ASAM, LOCUS, MCG criteria, and exhibit management prowess. The Account Manager will ensure efficient and compliant operations related to SA and MH medical records
  
  

Education and Experience:

• Bachelor’s or Master’s degree in a clinical field such as psychology, social work, or a related field. Advanced degrees preferred.
• Certification or specialized training in ASAM, LOCUS, MCG, or a combination thereof.
• Minimum of three (3) years of clinical experience with an emphasis in SA and MH.
• Management experience is a plus.
• Knowledge and proficiency in electronic health records (EHR) related to SA and MH.
• In-depth understanding of clinical assessment tools and criteria such as ASAM, LOCUS, and MCG.
• Has work within and is comfortable working within a matrixed structure.
  
  

Benefits

• Health Insurance
• Vision Insurance
• Dental Insurance
• 401(k) plan with matching contributions