BILLING SPECIALIST CCSEP

POSITION PURPOSE:Under the supervision of the Billing Specialist II the Billing Specialist performs a range of administrative billing support and reimbursement-related duties in support of Medi-Cal reimbursable behavioral health services. This position is responsible for the timely and accurate entry review and maintenance of client eligibility billing and service data within the Electronic Health Record (EHR). Duties include generating and reviewing routine billing service and error reports to identify documentation and charge discrepancies; coordinating with providers supervisors and program staff to ensure timely resolution of errors; verifying insurance eligibility; preparing and submitting billing-related documentation; and providing general administrative and customer service support to program OF ESSENTIAL DUTIES:The duties listed below are intended only as illustrations of the various types of work that may 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 insurance eligibility verification for Medi-Cal Medicare and Other Health Coverage (OHC) in accordance with program and billing requirements Tracks documents and follows up on corrections to ensure accurate and complete service records prior to billing submission Provides administrative and clerical support to program operations including preparing correspondence scheduling meetings maintaining calendars and responding to telephone inquiries Assists with electronic health record (EHR) and information system functions including data entry corrections report generation scheduling and billing support activities Collects organizes and prepares monthly program documentation and reports to support billing and reimbursement processes Develops organizes and maintains billing filing and recordkeeping systems to ensure accuracy and accessibility of records Creates updates and maintains databases and tracking systems related to program services billing and reporting requirements Assists in preparing monthly program billing productivity and mileage reimbursement reports Maintains confidentiality of protected health information in compliance with HIPAA County and program standards Completes all other duties as assignedDESIRED MINIMUM QUALIFICATIONS:Knowledge and Ability of:Knowledge of medical and behavioral health billing principles including Medi-Cal reimbursement requirements and County or County-contracted billing systems Experience with insurance eligibility verification and claims processes including Medicare and Other Health Coverage (OHC) Ability to generate review and analyze EHR billing and service data to identify and resolve errors Knowledge of documentation standards required to support Medi-Cal reimbursable services Familiarity with HIPAA regulations confidentiality requirements and compliance standards Experience working with culturally diverse populations and understanding of behavioral health-related social economic and systemic factors Ability to apply sound judgment within established policies and procedures Strong written and verbal communication skills Proficiency with computers EHR systems and standard office software applications Ability to operate standard office equipment and perform administrative support functionsCompletes all other duties as assigned by Supervisor and Program Director. Language Skills:Ability to effectively present information and respond to questions primarily in English from managers providers County billing staff clients and the general public; demonstrated skills in clear professional written and oral communication related to billing documentation and data correction Skills:Ability to add subtract multiply and divide using whole numbers common fractions and decimals; ability to review units dates of service and billing data for accuracy and Ability: Ability to define problems collect and review EHR and billing data establish facts and draw valid conclusions; ability to interpret technical billing instructions compliance requirements and documentation standards and apply them to service correction and billing support and Training:A high school diploma or G.E.D. equivalent and at least three (3) years of clerical billing or administrative experience in a healthcare behavioral health or social services setting with supervisory experience; Bachelors degree preferred and/or experience supporting MediCal billing processes in a County or Countycontracted program preferred; billing and financial training and/or certification highly desirable; experience and training in SmartCare or similar behavioral health EHR systems highly desirable; or an equivalent combination of training and experience. LICENSES CERTIFICATES & SPECIAL REQUIREMENTS:A Valid Drivers License with current California automobile insurance; A Valid Cardiopulmonary Resuscitation (CPR) Certification; A valid Tuberculosis (TB) test upon hire and updated every two to four (4) years depending on the contract requirements; PHYSICAL AND MENTAL DEMANDS:The physical and mental 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 essential Demands:While performing the duties of this class an employee is regularly required to sit stand and walk; talk or hear both in person and by telephone; use hands to operate finger handle or feel office equipment; reach with hands and arms; and lift up to 30 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Mental Demands:While performing the duties of this position employees are regularly required to communicate effectively both verbally and in writing; read interpret and apply information and documents; exercise problem-solving and organizational skills; learn and apply new procedures and information; and manage multiple detailed tasks simultaneously. The position requires the ability to work in a fast-paced environment with frequent interruptions changing priorities and deadlines while maintaining professionalism patience and a supportive approach when interacting with management staff vendors program participants including individuals with Serious Mental Illness (SMI) and members of the public who may at times be anxious upset or ENVIRONMENT:The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this class. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Employees work under typical office conditions and the noise level is usually quiet.