The Manager is responsible for managing and overseeing overall production of the Bill Review Department. They are also responsible for managing and supervising the Bill Review Assistants.  Minimum of ten (10) years of experience in California Workers’ Compensation Inpatient and Outpatient Fee Schedule Adjudication.

The Manager is responsible for managing and overseeing overall production of the Bill Review Department. They are also responsible for managing and supervising the Bill Review Assistants.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

• Ensuring Rush Bills identified by the Branch are processed in a timely manner.

• Assist Bill Review Department Supervisor with Analyst and Specialist workflow.

• Assist Bill Review Department Supervisor with counseling and corrective action necessary regarding the staff.

• Maintain and develop QI

• Active collaborator with Mitchell management team in addressing bill review problems.

• Audit Bill Review Assistant’s incoming and outgoing mail and counsel when necessary.

• Responsible for all workflow issues pertaining to production in department.

• Responsible for interviewing and hiring for the department.

• Daily oversight and review of unit/individual production stats.

• Responsible for proactively addressing any software or hardware issues with IT/Mitchell IT.

• Responsible for daily review/oversight of inventory reports to address turnaround time (paper vs. e-bills), timeliness of PPO re-pricing, provider file updates, etc.

• Manage existing capstone rule and identifying potential new capstone rules to facilitate production.

• Other duties may be assigned.

MINIMUM SUGGESTED QUALIFICATIONS:

• Minimum of ten (10) years of experience in California Workers’ Compensation Inpatient and Outpatient Fee Schedule Adjudication.
• Minimum of five (5) years of Management experience required.  • RN License is preferred not required; 4-year degree preferred. • Needs to be certified as an experienced Bill Reviewer and currently processing medical bills. • Certified Professional Coder Designation (CPC) preferred. • Certified Life Care Planner (CLCP) preferred. • Ability to create and understand a Medicare Set-Aside Agreement (MSA) preferred. • 3 years of Supervisory or Management experience. • ICD 10 and Medical Coding Certification. • Effective organizer, planner, self-starter and leader requiring minimal supervision. • Excellent oral and written communication skills.

SOFTWARE: Proficient in Microsoft Outlook, Excel, PowerPoint and Word. iVOS (preferred). Adept at accessing business data from the Internet when required.

PHYSICAL DEMANDS: While performing the duties of this job, the employee is regularly required to use manual dexterity, handle, or feel objects, tools, or controls; reach with hands and arms; and speak or hear. The employee frequently is required to walk, stand and sit. Position requires employee to frequently exert up to 10 pounds of force to move objects and occasionally exert up to 20 pounds of force to move objects.

REASONING ABILITY: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, verbal, diagram, or schedule form.

WORK ENVIRONMENT: Normally not exposed to conditions that are discomforting or disagreeable.