Billing Specialist

📋 Description

• Accurately prepare and submit claims, invoices, and necessary documentation for services, including coding for diagnoses and procedure codes.

• Monitor and track claims to ensure they are submitted promptly, while investigating and resolving any billing inaccuracies and related issues.

• Verify eligibility and benefits to determine each client's eligibility and check for additional private health insurance coverage.

• Collaborate with funders and insurance companies to address billing discrepancies and errors.

• Communicate with program and QA staff regarding any changes in a client’s eligibility status.

• Bill and collect copays/deductibles from parents or guardians in relevant programs.

• Upload files to the respective systems to apply payments and adjustments, and generate reports from the electronic health record system.

• Review billing denial queues and billing-related reports daily to ensure timely processing of claims and denials.

• Resubmit claims as necessary.

• Engage with program staff to discuss any corrections or required changes in documentation.

• Input, complete, and review billing and payment invoices using both internal and external Electronic Health Record (EHR) and Clearinghouse systems for assigned program(s) and submit reports punctually.

• Maintain accurate documentation for each claim, including details related to the approval or denial of claims, utilizing appropriate county forms and systems.

• Reconcile payments and address any discrepancies.

• Work with payers to appeal and rectify errors.

• Stay informed about updates in billing codes, regulations, and payer policies.

• Attend all mandatory trainings and meetings.

⛳️ Requirements

• Bachelor’s degree OR Associate degree plus 1 year of relevant work experience OR High school diploma/GED plus 2 years of relevant work experience.

• Relevant work experience includes data entry, claims processing, and revenue cycle billing.

• Familiarity with most Medical Insurance Payors, including Medi-Cal and commercial insurance, is preferred.

• Strong computer skills with a high level of proficiency in Excel.

• Proven organizational, analytical, and problem-solving skills, with the ability to advance issues toward resolution.

• Highly detail-oriented with strong skills in organizing, tracking, and managing substantial amounts of information.

• Must be at least 21 years of age.

• Clearance for TB testing, fingerprinting, and any other state or federal licensing or certification requirements.

🏝️ Benefits

• Starting salary ranges from $28.41 to $30.91 per hour.

• Annual salary increases.

• 5 weeks of Paid Time Off and 11 Paid Holidays.

• Comprehensive benefits package including medical, dental, vision, chiropractic, acupuncture, and fertility coverage.

• 50% paid premiums for dependents.

• Long-term disability, family leave, and life insurance options available.

• 403b Retirement Plan.

• Employer-funded Employee Assistance Plan.

• Opportunities for scholarships, ongoing training, and professional development.

• Seneca is recognized as a Public Service Loan Forgiveness certified employer.

• Opportunities for promotion across the agency in California and Washington.