Job Title: Billing Specialist 

Division: San Mateo/Santa Clara 

Department: Service Data Integrity Department (SDID) 

Reports To: Service Data Integrity Manager 

Classification: Starting at $27.00 Hourly DOEE, Full-Time, Non-Exempt 

About Us: Caminar and our divisions transformed the lives of nearly 17,000 youth and adults across Contra Costa, San Mateo, Santa Clara, San Francisco, Solano, and Butte counties last year through education, behavioral health care, and support. Driven by compassion, science, and our understanding of root causes, we deliver high-quality prevention, treatment, and recovery services to those with complex mental health, substance use, and co-occurring needs. 

Position Summary: The position of Billing Specialist is under the supervision of the Billing Manager and is responsible for billing Medi-Cal and other insurance for Mental Health and Substance Abuse Services. 

Essential Duties and Responsibilities include the following (other duties may be assigned): 

• Familiar with EHR systems
• Preparing and submitting medical claims to insurance companies, including 837's and 1500 forms.
• Ensuring patient's medical information is accurate and up-to-date.
• Preparing bills and and invoices, and documenting amounts due for medical procedures and services.
• Collecting and reviewing referrals and pre-authorizations.
• Monitoring and recording late payments.
• Achieving maximum reimbursement for services provided.
• Resolving complex denials.
• Identifying procedures and principal diagnosis performed on each patient and properly coding each procedure. 
• Batch error resolution, process deletions, and disallowance review.
• Research and resolve missing information.
• Scrub reports in all necessary systems and work closely with vendors to ensure timeliness, reporting needs, accuracy, client denials, etc.
• Develop processes and reports that can be turned over to clinicians whenever possible.
• Timely and accurate data entry of 42CFR & HIPAA protected client documentation into multiple electronic health record databases.
• Confirming client billing status and individual pay billing issues.
• Works client denials in order to resubmit claims for payment.
• Maintains service-provided records and accounts for insurance and other billable entities.
• Identifies and communicates effectively and immediately the errors found in billing and reports them to the Claims and Billing Coordinator.
• Process monthly billing of private pay insurance.
• Works collaboratively with admin team, supporting the efforts and needs of other departments, providing assistance in a team-oriented approach.
• Performs clerical tasks such as filing, copying, ordering supplies, faxing, and word processing. Receive, respond and initiate emails.
• Participate in department and agency trainings as assigned.
• Complete and submit accurate timecard to program management in timely manager.
• Must have excellent computer skills, be able to work with variety of databases to complete and provide analytical, and program support for a variety of services. 
• Respond to a variety of information requests from both inside and outside the agency
• Other support as needed

Competencies  

To perform the job successfully, an individual should demonstrate the following competencies: 

• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Interpersonal Skills - Maintains confidentiality.
• Written Communication - Able to read and interpret written information.
• Teamwork - Balances team and individual responsibilities; Gives and welcomes feedback; Willing to learn and be flexible and support the team.
• Managing People - Makes self-available to staff.
• Ethics - Works with integrity and ethically.
• Organizational Support - Follows policies and procedures; Completes administrative tasks correctly and on time; Excellent follow-up skills.
• Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Ability to multi-task and remain calm under pressure; Able to manage multiple priorities and work flow.
• Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position.
• Quality - Demonstrates accuracy and thoroughness; Attention to detail and completes projects from beginning to end.
• Quantity - Completes work in timely manner; Ability to think quickly and organized to complete all tasks.
• Safety and Security - Observes safety and security procedures; Determines appropriate action beyond guidelines.
• Adaptability - Adapts to changes in the work environment; Able to deal with frequent change, delays, or unexpected events.
• Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent.
• Dependability - Follows instructions, responds to management direction.
• Initiative - Asks for and offers help when needed; self-starter and proactive attitude

Qualifications 

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

• Education - High school diploma or general education degree (GED) required; Bachelors degree preferred.
• Experience - 1-3 years related experience; or equivalent combination of education and experience.
• Basic research techniques, procedures, and computer skills including the use of spreadsheets and database software
• Language skills - Ability to comprehend basic instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
• Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.
• Computer Skills - knowledge of Spreadsheet software and Word Processing software; strong data entry proficiency.
• Bi-lingual preferred, but not required.
• Knowledge of EHR preferred.

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 work day.
• Move about the office to access file cabinets, office machinery, etc.
• 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.

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.  

We've Got You Covered

Medical, Dental, and VisionHealth 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 AccountReceive tax savings on out-of-pocket health care costs.
 Employee Wellness ProgramWe’ll reimburse you for a portion of your gym/fitness dues. 

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

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

401(K) Retirement Savings PlanWe 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 BenefitsCommuting 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