Come work for a company that makes a difference within the communities of the State of California. This company works on cutting-edge prevention programming, providing counties with an independent administrative and fiscal intergovernmental structure. Our client helps fund, develop, and implement California's mental health services and educational programs. 

As a mental health organization, this company actively seeks to support qualified disabled candidates in obtaining employment with their company and is an Equal Opportunity Employer. Please complete the self-identification section of the application.

This company offers a VERY Generous Benefits Package, including:

• 10% company-sponsored retirement account (401a) 100% vested – additional compensation/retirement.
• Medical, Dental, Vision, LTD, Life Insurance, Wellness Program, FSA
• Generous PTO plan

Job Title: Senior Medical Billing Specialist – Revenue Cycle

Salary: $70k - $90k

Department: Informatics/EHR

Reports To:  EHR Management

FLSA Status: non-exempt

Location:  Sacramento, CA 

Work Model: REMOTE (preferably California but will consider qualified candidates in other states)

Schedule: Monday-Friday, 8am-5pm (Could vary depending on business needs)

JOB SUMMARY:

The Senior Medical Billing Specialist is the most senior medical billing specialist and performs complex, technical, and analytical tasks supporting the EHR billing function. Work also involves entering, verifying, researching, coding, correcting, or retrieving information from source documents and/or computer systems with a high level of accuracy.

DUTIES AND RESPONSIBILITIES  include but are not limited to:

• Become a subject matter expert for the medical billing department for billing processes and the technology used (i.e., SmartCare).
• Serve as medical billing point of contact for county representatives.
• Process remittances and take appropriate actions, including:
• Posting appropriate payments/adjustments/transfers
• Perform follow-up and error correction to support re-billing of denied claims.
• Re-bill denied, and all claims to successful completion.
• Perform audits –
• Create and run various reports; review and analyze information to monitor billing activities.
• Discern billing trends and identify performance improvements.
• Prepare and submit claims electronically or by paper to private health and County/State insurance companies. Contact insurance companies to correct billing issues and resubmit claims to third-party payers.
• Research and resolve complex billing issues.
• Create and maintain reports from the application database by tracking billings; monitoring collections; compiling information.
• Identify billing errors by interpreting transactions. Follow and report on the status of all billing transactions.
• Assists medical billing management with coordinating various billing functions to ensure proper execution of billing revenue cycle duties.
• Perform data validation and submission for other non-billing State reporting requirements.
• Review patient records on a daily basis for accuracy, supply any missing information, and ensure compliance with company policy and government regulations.
• HIPAA - Assist in establishing and maintaining the security of medical records to ensure patient confidentiality on an ongoing basis.
• Access patient records as needed for review by physicians, technicians, and other medical staff members.
• Follow professional standards and meet local, state, and federal regulations requirements.
• Other duties as assigned

Required Education/Experience:

Possesses a high school diploma or equivalent. Medical Billing Certification and seven (7) years of medical billing experience, preferably in behavioral health or an acceptable equivalent combination of education and experience. Experience must include extensive experience using EHR software. To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements below represent the experience, knowledge, skill, and/or ability required.

• This is a technical position and requires someone who is tech savvy, analytical, and has the ability to navigate EHR instruction manuals well.
• Customer-centric mindset
• Excellent communication, interpersonal, leadership, coaching, and conflict-resolution skills.
• Excellent speaking and writing skills.
• Excellent collaboration and team-focused skills and experience.
• Expert understanding of insurance terminology (out-of-network benefit s vs. in-network benefits, as well as coinsurance, co-pays, and deductibles), in addition to general billing practices.
• Knowledge of cash postings, billing, follow up, insurance registration, authorization management and claim denials.
• Knowledge of Professional billing (CMS1500)
• Knowledge and experience with EHR and billing software programs required.
• Possesses and demonstrates professional telephone demeanor and appearance.
• Demonstrates the ability to work in a fast-paced environment; can multi-task and work independently as well as with a team.
• Displays the ability to keyboard 30 wpm; is proficient in Word, Excel and Outlook.
• Must be willing to travel, when necessary.

COMPUTER SKILLS – Demonstrate the ability to use a computer and applicable computer software effectively. Intermediate knowledge of Excel & Word, Adobe, PowerPoint, and Outlook. Experience with DocuSign and any other project management product software required. This position is highly technical - one must be able to demonstrate an appropriate level of technological skills to be effective in this position.

LANGUAGE SKILLS and MATHEMATICAL SKILLS - Demonstrate the ability to read, comprehend, and respond appropriately through written or verbal form; demonstrate tactfulness when communicating, including internal communication with staff members of all levels; ability to communicate with a variety of audiences effectively. Ability to add, subtract, multiply, and divide in all measure units using whole numbers, common fractions, and decimals.

REASONING – Demonstrate the ability to effectively apply common sense and follow through to daily tasks; demonstrate the ability to work with little or no supervision; demonstrate excellent analytical skills; demonstrate the ability to efficiently conduct research and ask appropriate probing questions to complete necessary tasks.

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. While performing the duties of this job, the employee is frequently required to sit and stand; use a phone and headset; use hands, arms, and fingers to type; answer phones; write; use a calculator; demonstrate strength to lift and carry materials weighing up to 10 pounds; demonstrate clear vision to read printed materials and a computer screen; hearing and speech to communicate in person and over the telephone; and drive a motor vehicle on public roads and highways.

SENSORY DEMANDS - The incumbent must spend long hours in intense concentration. The incumbent must also spend long hours on the computer entering information which requires attention to detail and high levels of accuracy.

MENTAL DEMANDS - There are a number of deadlines associated with this position, which may cause significant pressure. The incumbent must also deal with a wide variety of people on various issues.

REGULAR WORK SCHEDULE – Varies depending on business needs; however, the company's regular business hours are 8:00 am to 5:00 pm, Monday – Friday.

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