CVHI Specialist

Responsibilities

• Maintains accurate financial records and ensures compliance with state and federal rules and regulations.
• Coordinates the managed care billing process, including managing local relationships with third-party insurance and ensuring services comply with contractual and reimbursement policies.
• Ensures the program complies with the established funding agreement with CalVet.
• Maintains and monitors all financial records to ensure accuracy, completeness of data, and compliance with state and federal rules and regulations.
• Establishes and monitors policies and procedures pertaining to grant operations, risk management, and business continuity.
• Collaborates with staff around tracking financials, trends, and reporting.
• Manages administrative staff to ensure all organizational standards are being followed.

Qualifications

• Bachelor’s degree from an accredited college or university with at least 5 years of relevant experience.
• At least 5 years of experience working with third-party payers, coding, billing, posting, and adjudication of claims.
• At least 3 years of experience collecting, analyzing, and reporting financial data.
• Demonstrated knowledge about the appropriate and effective use of protected health information, the Health Insurance Portability and Accountability Act of 1996, and the Health Information Technology for Economic and Clinical Health Act.
• Excellent customer service skills.
• Must be able to work independently, as part of a team, anticipate problems, generate solutions, and demonstrate flexibility and sensitivity when engaging with staff and clients.
• Excellent written and oral communication skills; ability to digest and distill complex subjects into clear messages.
• Experience working with military populations and/or veterans is strongly preferred.
• Valid driver’s license required and must be able to meet company insurance standards for drivers if applicable.