The Clinic Supervisor is responsible for planning, organizing and influencing the Urgent Care Staff activities and the delivery of Business Services while maintaining continuous quality improvement. The Clinic Supervisor maintains operations within budgetary parameters. Effectively interacts with patient, physicians, and other health team members while maintaining standards of professional business conduct and service. The Clinic Supervisor is accountable to the Director and Executive Director for the day-today management of personnel, including staffing, credential monitoring, time-keeping, employee evaluation, counseling, interview and selection of staff within established SMMG and regulatory guidelines. The Clinic Supervisor spends 80% + of his/her time is spent on the aforementioned...

Under the supervision of the Director, the Payment Review Specialist position is responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Utilizing many complex and varying regulations, guidelines and systems, analyzes payments received from insurance companies to assure maximum and correct reimbursement of Hospital�s receivables. Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment. Utilizes and applies the appropriate State and Federal regulations in order to assure compliance in payment practices.

The Biller is responsible for submitting claims to the appropriate intermediaries and to ensure that procedures and charges are coded in compliance with all payers including Medi-Cal and/or Medicare regulations. Responsible for obtaining required authorizations necessary for the processing and payment of claims. The Biller is responsible for the follow-up and denial management as necessary for final resolution. Responsible to identify the various types of diagnosis and procedures codes (ICD9, CPT, HCPCS, DRG) as they relate to reimbursement. Communicates clearly and efficiently by phone and in person with clients and staff members. Maintains productivity standards and reports. Obtains updated demographic information and all necessary information needed to comply...