Billing Specialist II

Description

Job Title:            Billing Specialist II

Division:            Santa Clara/San Mateo

Department:      Agency Administration/ Finance & Accounting

Reports To:         Billing Supervisor

Classification:   Starts at $32.00 Hourly, DOEE Full-Time, Non-Exempt

Location: Remote

About Caminar: Caminar is a leading behavioral health organization that supports youth and adults across multiple counties in Northern California and the San Francisco Bay Area. Caminar builds strength and stability through comprehensive mental health and substance use treatment, and wrap-around services, delivered through evidence-based, whole-person care. Founded in 1964, Caminar's vision is to be a beacon of safety, compassion, and fulfillment, supporting all those in our communities who need it most. Our mission is to build strength and stability through comprehensive mental health and substance use treatment delivered through evidence-based, whole-person care.

Position Summary:

Essential Duties and Responsibilities:

• Maintain and upkeep current policies and procedures that relate to billing and data collection.
• Communicate information and reports directly to Supervisor
• Compose and deliver reports requested by RED, RDO, and Caminar Finance department on weekly, monthly, and annual basis.
• Be able to read, translate, and understand data that is reflected in reporting and utilize understanding to correct issues in a prompt and reasonable timeframe.
• Have working knowledge/understanding of electronic health records (EHR), excel, Microsoft word, and PowerPoint.
• Scrub reports in all necessary systems and work closely with vendors to ensure timeliness, reporting needs, accuracy, client denials, etc.
• Understand and comply with how to manage 42CFR & HIPAA protected client documentation into multiple electronic health record databases.
• Works collaboratively with all agency teams, supporting the efforts and needs of other departments, helping in a team-oriented approach.
• Participate in department and agency trainings as assigned.
• Respond to a variety of information requests from both inside and outside the agency.

• Identifying procedures and principal diagnosis performed on each patient and properly coding each procedure 
• Inputting charges, payments and adjustments to computerized system or posting to manual records 
• Managing temporary and internship staff on Medicaid posting project 
• Revamping updating process for ICD-10 codes to ensure that federal/state changes 
• Coding all claims interpret in EOMB's from Medicare & EOB from insurance companies (Medi-Cal) 
• Resolving incorrect insurance payments, EOB denials, and any issues with outstanding accounts 
• Collecting delinquent accounts, and following up with insurance companies  
• Tracking billings, monitoring collections and compiling information to maintain county billing requirments.
• Converting medical dosages to billable units 
• Preparing and submitting billing data and medical claims to insurance companies 
• Ensuring each patient’s medical information is accurate and up to date 
• Preparing bills and invoices and documenting amounts due to medical procedures and services 

• Other duties as assigned.

• Education– High school diploma or general education degree (GED) required;
• Experience – 5+ years of direct billing experience, specifically with Government and Commercial payors.  Should have a strong understanding of CPT codes and use of modifiers.
• Three years full-time professional experience in Medi-Cal billing and compliance, and performance standards applicable to community-based care programs.
• Must have excellent computer skills, including extensive work with Microsoft Office (Word, Excel, Outlook, etc.).
• Ability to maintain a high level of confidentiality, a professional demeanor and to always represent the organization in a positive manner.
• Problem solving—identifies and resolves problems in a timely manner and gathers and analyzes information skillfully.
• Oral and written communication—speaks clearly and persuasively in positive or negative situations, demonstrates group presentation skills, and conducts meetings.
• Planning/organizing—prioritizes and plans work activities, uses time efficiently and develops realistic action plans.
• Adaptability—adapts to changes in the work environment, manages competing demands, and can deal with frequent change, delays, or unexpected events.
• Dependability—is consistently at work and on time, follows instructions, responds to management direction, and solicits feedback to improve performance.
• Safety and security—actively promotes and personally observes safety and security procedures and uses equipment and materials properly.
• Must be a dynamic self-starter with demonstrated ability to work independently on special projects.

Physical Demands:

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.

While performing the duties of this Job, the employee is regularly required to:

Communicate with clients and co-workers to exchange accurate information.

Frequently required to remain in a stationary position for most of the workday.

Constantly operates a computer and other office machinery, such as copy machine, printer, fax.

Must be able to review client charts for accuracy and information.

• Special Requirements:
  • Must be able to meet and receive a criminal records clearance, as required by Title XXII, other licensing regulations, and Caminar practices.
  • Must be able to pass post offer, pre-employment medical and drug tests as required under State Community Care Licensing regulations and/or agency policies.
  Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time based on business need. This job description is subject to change at any time. Caminar is a leader in providing innovative client-oriented mental health services. We are an equal opportunity employer. Please visit our web site at www.caminar.org

We've Got You Covered

 Medical, Dental, and Vision
Health coverage choices to fit you and your family’s needs. A zero-cost option for employee only and generous contributions to employee and dependent premiums.

 Flexible Spending Account
Receive tax savings on out-of-pocket health care costs.
 
Employee Wellness Program
We’ll reimburse you for a portion of your gym/fitness dues.

 Life, Long-term Disability,and AD&D Insurance
Provided at no cost to our full-time employees. Includes an option to purchase additional life coverage for both employees and dependents.

 Paid Time Off
We offer twelve paid holidays and a generous sick and vacation benefit.

401(K) Retirement Savings Plan
We offer options for both pre-tax and post-tax (Roth) contributions. 
 The plan also offers an employer match on eligible employee deferrals at one year of service.

Commuter Benefits
Commuting to work each day can be expensive. Receive tax savings on your commuting costs!
 

Employee Assistance Program
 For whatever issue you might face, our Life Assistance Program offers free, confidential assistance at no cost to you.

Caminar is a leader in providing innovative client-oriented mental health services.  We are an equal opportunity employer.  Please visit our web site at www.caminar.org