Patient Account Services Lead (30379)

Why work for Ampla Health? ​​​​​​​ 30379

Ampla Health provides the individuals and communities we serve with high quality, comprehensive, community health care that is accessible to all and culturally and linguistically appropriate.

• Great Benefits including Medical, Dental, and Vision
• 4 weeks paid time off to start.
• 9 paid holidays
• 401k and profit sharing
• Full time, Monday to Friday
• Great work/home life balance

General Purpose

Under the direction of the PAS Supervisor, the Patient Account Services Lead serves as the department's technical resource and workflow coordinator. This position performs advanced billing and accounts receivable functions while providing daily guidance, training, quality review, and support to PAS Representatives.

Key Responsibilities

• Serve as the daily resource and lead for PAS Representatives.
• Provide guidance on billing regulations, payer requirements, and best practices.
• Assist with staff onboarding, training, coaching, workload distribution, and productivity monitoring.
• Perform Patient Account Services Representative duties and resolve complex billing issues, claim edits, denials, and payer escalations.
• Monitor aging accounts, timely filing, cash collections, and denial trends.
• Assist with PPS reimbursement monitoring, encounter accuracy, reimbursement variance analysis, and coding/documentation review.
• Serve as a subject matter expert for Medicare, Medi-Cal, Managed Care, FQHC, and PACE billing.
• Perform quality audits and identify recurring errors and training opportunities.
• Analyze billing and reimbursement reports and recommend improvements to reduce denials and accounts receivable.
• Assist with Practice Management system testing, upgrades, workflow changes, and troubleshooting.
• Develop and maintain workflow documentation and standard operating procedures.
• Resolve escalated patient billing concerns and collaborate with Coding, Finance, IT, Credentialing, and Clinical Operations.
• Perform other duties as assigned.

Qualifications & Requirements

• Minimum five (5) years of healthcare billing experience required.
• Minimum two (2) years of FQHC billing experience preferred.
• Associate degree in Business, Healthcare Administration, or related field preferred.
• Experience with Medicare, Medi-Cal, and Managed Care billing required.
• Knowledge of FQHC billing, PPS reimbursement, encounter-based billing, and payer requirements.
• Working knowledge of CPT, ICD-10, and HCPCS coding.
• Strong knowledge of denial management, A/R follow-up, and claim resolution.
• Experience mentoring or training staff preferred.
• Strong analytical, problem-solving, organizational, and leadership skills.
• Proficiency with Practice Management systems, Microsoft Office, and Excel.

Physical Requirements

• Ability to communicate effectively by telephone and in person.
• Ability to lift up to 50 pounds.
• Adequate vision to read computer screens and documents.
• Ability to bend, squat, sit, stand, stoop, crouch, reach, kneel, and twist/turn.
• May be exposed to contagious/infectious diseases.