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Lead, Patient Financial Services, Billing and Follow up (On-Site/Hybrid/Remote)

Northbay Healthcare

Fairfield, CA(remote)

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JOB DETAILS
JOB TYPE
Full-time
SKILLS
Accounts Receivable, Acute Care, Analysis Skills, Auditing, Automation, Billing, Cancer, Cardiovascular, Case Management, Communication Skills, Compensation and Benefits, Content Management Systems (CMS), Contract Requirements, Corrective Action, Credit and Collections, Customer Support/Service, Denials Management, Detail Oriented, Documentation Standards, Epic Resolute (Patient Accounting), Establish Priorities, Federal Laws and Regulations, Financial Audit, Financial Services, Frequently Asked Questions (FAQ), Healthcare, Hospital, Interpersonal Skills, Leadership, Maintain Compliance, Medi-Cal, Medical Billing, Medicare, Microsoft Excel, Microsoft Office, Neonatal Intensive Care Unit (NICU), Neuroscience, Nonprofit, Operational Support, Organizational Skills, Orthopedics, Patient Care, Performance Management, Performance Metrics, Physical Demands, Policy Development, Presentation/Verbal Skills, Primary Care, Problem Solving Skills, Procedure Development, Process Improvement, Project Tracking, Reconciliation, Regulations, Regulatory Requirements, Reimbursement, Reporting Dashboards, Reporting Skills, Root Cause Analysis, Staff Requirements, State Laws and Regulations, Support Documentation, Surgical Procedures, Team Lead/Manager, Team Player, Time Management, Training/Teaching, Trend Analysis, Urgent Care, Work From Home, Writing Skills
LOCATION
Fairfield, CA
POSTED
11 days ago
Work Location Requirement and Preference: This position may be performed onsite or remotely; however, onsite work is preferred based on business needs. Preference will be given to qualified candidates who are able to work onsite and are located within a commuting distance to Fairfield, CA.Remote Work Eligibility:This position is open to candidates located within the continental United States. Due to state-specific employment requirements and workers’ compensation regulations, we are unable to support remote work arrangements in the following locations: Washington, Ohio, Wyoming, North Dakota, Puerto Rico, and the U.S. Virgin Islands.At NorthBay Health, the Lead, Patient Financial Services Billing and Follow-up provides advanced operational oversight and subject matter expertise supporting Supervisors and staff responsible for billing, follow-up, and collections of hospital patient accounts.This role serves as a senior escalation resource and workflow leader, ensuring timely, accurate billing and follow-up activities across all major payer groups, including Medi-Cal, Medicare, and Commercial payers. The Lead is responsible for helping with daily performance, resolving complex accounts, ensuring regulatory compliance, and supporting revenue cycle outcomes including cash collections, denial prevention, and A/R reduction.Acts as a liaison between frontline staff, Supervisors, and leadership to optimize workflows, standardize processes, and improve overall team performance.PRIMARY JOB DUTIESProvide day-to-day operational leadership and support to supervisors and staff across billing and A/R follow-up functions. Serve as the primary subject matter expert (SME) for Medi-Cal, Medicare, and Commercial payer billing and follow-up, including payer-specific rules, reimbursement methodologies, and escalation pathways. Review and resolve complex or high-dollar accounts, including denials, underpayments, and aged A/R across all payer types. Monitor work queues and ensure timely billing, follow-up, and account resolution in alignment with departmental KPIs and regulatory requirements. Partner with supervisors to drive staff productivity, quality, and accountability for A/R performance, cash collections, and denial resolution. Analyze payer trends (Medi-Cal, Medicare, Commercial) to identify root causes of denials, delays, and underpayments; recommend and implement corrective actions. Ensure compliance with all federal and state regulations, including CMS guidelines, Medi-Cal requirements, and payer contract terms. Provide advanced training, education, and real-time coaching to staff and supervisors on billing processes, payer requirements, and system workflows. Assist supervisors with auditing staff performance, accounting quality, and documentation standards. Support the development and standardization of workflows, policies, and procedures related to billing and A/R follow-up. Collaborate with internal departments (coding, HIM, case management, customer service) and external stakeholders (payers, vendors) to resolve issues and improve revenue cycle performance. Function as escalation point for payer issues requiring advanced research, including appeals, reconsiderations, and payment discrepancies. Assist leadership in preparing reports, dashboards, and performance summaries related to A/R, denials, and cash collections. Support system optimization efforts (Epic, clearinghouses, payer portals) to improve efficiency and automation. Lead or participate in special projects focused on revenue cycle improvement, denial reduction, and cash acceleration.Education: Associate’s degree preferred or equivalent combination of education and/or 4 years of relevant experience.Licensure / Certification: All new hires will be required to complete the HFMA Certified Revenue Cycle Representative (CRCR) training course within the first nine (9) months of employment. The employer will sponsor membership, training, and certification costs.Experience Minimum 5–7 years of experience in hospital or professional billing and A/R follow-up Advanced experience with Medi-Cal, Medicare, and Commercial payer processes Prior Lead or senior-level experience preferred. Strong background in denials management, appeals, and payer resolution Experience with revenue cycle systems (e.g., Epic Resolute preferred)Skills & CompetenciesExcellent oral and written communication skills.Proficient in PC applications and Microsoft Office Suite, specifically Excel.Strong analytical skills with exceptional attention to detail.Skilled in training and providing education to staff.Strong organizational skills and ability to prioritize tasks effectively.Interpersonal SkillsAbility to prioritize tasks and communicate delays effectively.Strong interpersonal communication skills across all organizational levels.Ability to supervise a team with professionalism, inclusion, and effective communication.Standards of Performance: Demonstrate performance by adhering to established policies and procedures and exhibiting the defined characteristics associated with attendance and punctuality. Physical Effort: Attendance is an essential function of the job. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.About UsInterpersonal Skills and ValuesDemonstrates NorthBay Health’s True North Values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high-quality patient care.Why NorthBay HealthNorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions.We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities.NorthBay Health Benefits OptionsNorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance.Compensation StructureNorthBay Health uses a structured compensation framework. Staff-level positions use a step-based system (Steps 1–5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements.Remote Work DisclosureNorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs.Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States.Notice to Recruitment AgenciesNorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings.More InformationVisit NorthBay Health Careers for recruitment FAQs and additional information.

About the Company

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Northbay Healthcare