Billing Specialist

Job Description

Job Description

ESSENTIAL DUTIES AND RESPONSIBILITIES – (ILLUSTRATIVE ONLY)

The duties listed below are intended only as illustrations of the various types of work that could be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to this class.

• Tracks all payments and denials.
• Works cooperatively with programs to maximize billing and minimize denials.
• Monitors billing errors and works with staff to correct any EHR data issues that affect billing.
• Tracks and monitors billing discrepancies.
• Provides billing status reports upon request.
• Works collaboratively with programs and departments to correct discrepancies and maintain the accuracy and timeliness of billing and reporting.
• Works collaboratively with Managed Care Plans and other payors to submit, correct or void billing in a timely manner.
• Ensures that coding for billing is accurate and that billing is accurate so as to avoid rejection.
• Performs Medi-Cal, Medicare eligibility verification.
• Assists with ensuring that programs meet the billing standard monthly.
• Assists with data entry in EHR as needed.
• Provides billing training and support to program support staff as needed.
• Maintains orderly, accurate records and documentation.
• Safely travels on agency business using personal vehicle.
• Maintains clean driving record as well as currency in driver’s license and vehicle insurance/registration.
• Travel between sites as needed.

QUALIFICATIONS

MINIMUM:

At least one (1) year of experience with an EHR with emphasis and education in Managed Care Plan and Medicare/Medicaid/Medi-Cal billing and coding. Must have knowledge of the public mental health system, ICD codes, CPT/HCPCS and EOB adjudication codes; must be able to type 40-50 wpm and must be computer literate; must be proficient in Microsoft Word, Access, and Excel.

PREFERRED:

Familiarity with CalAim, MCP-specific nuances, and Enhanced Care Management billing categories.

OPTIMUM:

Registered Health Information Technician (RHIT) certification or an AA/AS in insurance billing and coding; accounting, business management or other related field and at least two (2) years’ experience with an EHR; must be proficient with computers; must be proficient with Microsoft Word, Access and Excel.

LICENSES; CERTIFICATES; SPECIAL REQUIREMENTS

• California driver’s license & current vehicle insurance/registration if driving; and,
• Reliable means of transportation capable of passing vehicle safety inspection if more than five years old excluding all modes of two-wheeled transport inclusive of bicycles, mopeds and motorcycles.

Hours: Monday to Friday

Compensation: $32 to $34.64

KNOWLEDGE AND ABILITIES
Knowledge Of

• Knowledge of data base searches.

Ability To

• Ability to communicate effectively orally and in writing.
• Proficiency with 10-key adding machine.
• Ability to work and communicate effectively with staff, members, community agencies, and professionals.
• Ability to work effectively under stress and conflict.
• Ability to exercise appropriate judgment and decision making.
• Ability to be flexible and adaptable in any given situation.
• Ability to follow through on projects.
• Must possess high degree of organizational/prioritizing skill.

SKILLS

• Billing
• Providing billing status reports
• Providing billing training
• Maintain records
• Accuracy
• Decision-making
• Self-discipline
• Organization
• Communication
• Stress-management

MENTAL AND PHYSICAL DEMANDS

The mental and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this class. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Mental Demands

While performing the duties of this class, the employee is regularly required to use written and oral communication skills; read and interpret data, information and documents; analyze and solve complex problems; use math and mathematical skills; perform highly detailed work under intensive deadlines on multiple, concurrent tasks; work with constant interruptions, and interact with TPCP management,

administrators, staff, applicants, representatives of external agencies and others encountered in the course of work.

Essential Physical Functions

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 accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical Demands

While performing the duties of this class, an employee is regularly required to sit; talk or hear, both in person, and by telephone; use hands to finger, handle, feel or operate standard office equipment; and reach with hands and arms. The employee is frequently required to walk and stand and lift up to ten pounds. Additionally, specific vision abilities required by this job include close vision and the ability to adjust focus.

Move around occasionally, stand occasionally, sit frequently, twist at waist or neck occasionally, twist at neck occasionally, use fine finger manipulation frequently, use simple grasping occasionally, use power grasping seldom, reach with either hand occasionally, reach above shoulder height seldom, reach at shoulder height occasionally, lift less than 10 pounds occasionally and more than 10 pounds seldom, carry any weight over 10 feet seldom, bend at waist seldom, travel occasionally.

There are no unusual conditions. Typically, the noise level in the work environment is moderate.