Contra Costa County
Patient Account (Claims) Manager
Contra Costa County, California, Missouri, United States, 65018
Join to apply for the
Patient Account (Claims) Manager
role at
Contra Costa County
This role offers a base pay range of $118,044.68/yr - $143,484.04/yr.
Contra Costa Health (CCHP) is a federally qualified, state‑licensed, and county‑sponsored Health Maintenance Organization serving over 250,000 residents in Contra Costa County. As a Patient Accounting Manager, you will oversee claims operations to ensure accurate, timely processing and compliance with Medi‑Cal, Medicare, and commercial payer requirements, supporting the plan’s mission to provide equitable, high‑quality care.
What you will typically be responsible for:
Managing and supervising claims operations for CCHP, including claims processing, adjustments, and payment integrity.
Selecting, training, evaluating, and monitoring the performance of subordinate personnel, including supervisors and clerical staff.
Overseeing workflows to ensure timely and accurate adjudication of claims across Medi‑Cal, Medicare, and commercial lines of business.
Serving as liaison with providers, county healthcare staff, and external stakeholders to resolve claims‑related issues.
Ensuring compliance with federal, state, and local regulations and managed‑care, Medi‑Cal, and Medicare standards.
Monitoring claims performance metrics, including timeliness, accuracy, and compliance with DHCS, DMHC, and CMS requirements.
Reporting key claims issues, trends, and operational updates to higher management in a timely manner.
Collaborating with Finance, Utilization Management, Compliance, and other divisions to align claims operations with organizational goals.
Key attributes we value:
Experienced in Managed Care:
Direct experience in health plan claims operations within a managed care environment.
Knowledgeable in Medicaid and Medicare:
Understanding of Medi‑Cal and Medicare program requirements, including billing, payment, and compliance.
A Strong Communicator:
Able to clearly explain complex billing and claims issues to staff, providers, and leadership.
Solution‑Oriented:
Positive attitude and commitment to continuous improvement.
Professional and Collaborative:
Excels at working in a team environment while maintaining accountability.
Discreet and Judicious:
Good judgment in handling confidential and sensitive matters.
Supportive:
Invests in the training, coaching, and professional development of staff.
A few challenges you might face:
Adapting to constantly evolving federal, state, Medi‑Cal, and Medicare claims regulations.
Managing multiple competing deadlines in a high‑volume claims environment.
Providing clear and effective communication when conflicts or discrepancies arise.
Maintaining deep knowledge of complex billing and payment requirements across Medicaid, Medicare, and commercial insurance lines.
Delivering Results:
Meeting organizational goals and customer expectations through accurate, timely claims processing.
Legal & Regulatory Navigation:
Understanding, interpreting, and ensuring compliance with laws and regulations.
Ownership & Accountability:
Holding self and others accountable for high‑quality, efficient results.
Handling stress, maintaining composure under pressure, and communicating solutions to diverse stakeholders.
Minimum Qualifications Education:
Bachelor's degree in business administration, finance, accounting, health care administration, or a closely related field.
Experience:
Three (3) years full‑time or equivalent managerial experience in patient accounting or related health care services.
Substitution for Education
Associate’s degree + two (2) years additional qualifying experience may substitute for the required Bachelor’s degree;
OR
Professional certifications (CHFP, CPAM, CCAM, CPAT, CCAT) plus four (4) years additional qualifying experience may substitute for the required Bachelor’s degree.
Substitution for Experience and Education Five (5) years of full‑time experience as an Account Clerk Supervisor in Contra Costa County may substitute for the required education and experience.
Selection Process
Application Filing and Evaluation:
Applicants complete a supplemental questionnaire; evaluations determine progression.
Remote Oral Assessment:
Selected candidates complete an online assessment measuring competencies; a 70% passing score overall is required.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Accounting/Auditing and Management
Industries: Government Administration; Hospitals and Health Care
We offer a generous benefits package and a competitive retirement plan.
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Patient Account (Claims) Manager
role at
Contra Costa County
This role offers a base pay range of $118,044.68/yr - $143,484.04/yr.
Contra Costa Health (CCHP) is a federally qualified, state‑licensed, and county‑sponsored Health Maintenance Organization serving over 250,000 residents in Contra Costa County. As a Patient Accounting Manager, you will oversee claims operations to ensure accurate, timely processing and compliance with Medi‑Cal, Medicare, and commercial payer requirements, supporting the plan’s mission to provide equitable, high‑quality care.
What you will typically be responsible for:
Managing and supervising claims operations for CCHP, including claims processing, adjustments, and payment integrity.
Selecting, training, evaluating, and monitoring the performance of subordinate personnel, including supervisors and clerical staff.
Overseeing workflows to ensure timely and accurate adjudication of claims across Medi‑Cal, Medicare, and commercial lines of business.
Serving as liaison with providers, county healthcare staff, and external stakeholders to resolve claims‑related issues.
Ensuring compliance with federal, state, and local regulations and managed‑care, Medi‑Cal, and Medicare standards.
Monitoring claims performance metrics, including timeliness, accuracy, and compliance with DHCS, DMHC, and CMS requirements.
Reporting key claims issues, trends, and operational updates to higher management in a timely manner.
Collaborating with Finance, Utilization Management, Compliance, and other divisions to align claims operations with organizational goals.
Key attributes we value:
Experienced in Managed Care:
Direct experience in health plan claims operations within a managed care environment.
Knowledgeable in Medicaid and Medicare:
Understanding of Medi‑Cal and Medicare program requirements, including billing, payment, and compliance.
A Strong Communicator:
Able to clearly explain complex billing and claims issues to staff, providers, and leadership.
Solution‑Oriented:
Positive attitude and commitment to continuous improvement.
Professional and Collaborative:
Excels at working in a team environment while maintaining accountability.
Discreet and Judicious:
Good judgment in handling confidential and sensitive matters.
Supportive:
Invests in the training, coaching, and professional development of staff.
A few challenges you might face:
Adapting to constantly evolving federal, state, Medi‑Cal, and Medicare claims regulations.
Managing multiple competing deadlines in a high‑volume claims environment.
Providing clear and effective communication when conflicts or discrepancies arise.
Maintaining deep knowledge of complex billing and payment requirements across Medicaid, Medicare, and commercial insurance lines.
Delivering Results:
Meeting organizational goals and customer expectations through accurate, timely claims processing.
Legal & Regulatory Navigation:
Understanding, interpreting, and ensuring compliance with laws and regulations.
Ownership & Accountability:
Holding self and others accountable for high‑quality, efficient results.
Handling stress, maintaining composure under pressure, and communicating solutions to diverse stakeholders.
Minimum Qualifications Education:
Bachelor's degree in business administration, finance, accounting, health care administration, or a closely related field.
Experience:
Three (3) years full‑time or equivalent managerial experience in patient accounting or related health care services.
Substitution for Education
Associate’s degree + two (2) years additional qualifying experience may substitute for the required Bachelor’s degree;
OR
Professional certifications (CHFP, CPAM, CCAM, CPAT, CCAT) plus four (4) years additional qualifying experience may substitute for the required Bachelor’s degree.
Substitution for Experience and Education Five (5) years of full‑time experience as an Account Clerk Supervisor in Contra Costa County may substitute for the required education and experience.
Selection Process
Application Filing and Evaluation:
Applicants complete a supplemental questionnaire; evaluations determine progression.
Remote Oral Assessment:
Selected candidates complete an online assessment measuring competencies; a 70% passing score overall is required.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Accounting/Auditing and Management
Industries: Government Administration; Hospitals and Health Care
We offer a generous benefits package and a competitive retirement plan.
#J-18808-Ljbffr