Medical Billing Program Specialist II

Work Location: 310 Beck Ave, Fairfield, CA 94533

Employment Details: Full Time, Non-Exempt, Monday - Friday from 8 AM - 4:30 PM or 8:30 AM - 5:00 PM

Compensation: $23.50 - 30.25/hour

PURPOSE of ROLE: This position will prioritize and manage the medical & CalAIM billing for the campus. This will entail the focus, tracking of services, communication with, and submittal of billing for provided services.  This position also has a key element of  administrative support to program and staff, including ad hoc assignments, to meet program and agency needs. This role includes clerical tasks such as answering calls and returning calls, file and document management, assisting with participant information, data input in to systems, and collecting documentation. Upon occasion, intakes will also be supported.

RESPONSIBILITIES:

ADMINISTRATIVE

·       Respond to calls and emails, providing high quality customer service by responding promptly, accurately, and professionally to all inquiries and requests for assistance.

·       Track and document billable services; prepare, submit, and monitor CalAIM/Medi-Cal billing claims; review claims for accuracy and completeness; research and resolve denied or rejected claims; maintain billing records and supporting documentation; and prepare billing-related reports to ensure compliance with agency, funding, and regulatory requirements.

·       Provide intake support by assisting with client screenings, intake paperwork, eligibility verification, appointment scheduling, and record maintenance.

·       Assist with preparation, distribution, and filing of correspondence, notices, invitations, reports, files, etc.

·       Assist with program/client/tenant file audits to ensure program regulatory compliance.

·       Prepare scheduled and ad-hoc reports and validate for accuracy.

·       Provide administrative support to supervisor and assigned team.

·       May serve on internal committees as needed.

·       Serves as backup for certain positions as needed for employee breaks, meal periods, vacation and sick leave coverage.

·       Other administrative duties as assigned.

DATA DOCUMENTATION

·       Keep all relevant data up to date in applicable systems and databases (HMIS, Yardi, Intacct, Office Ally, Rippling, etc.)

·       Maintain electronic files in accordance with applicable guidelines, completing data entry timely.

·       Participate in service trainings for front (client) facing staff when assigned.

·       Perform other data or program duties as requested.

PROGRAM SPECIFIC (VARIES BASED ON TEAM):

·       Screening prospective participants for eligibility of services.

·       Acting as a liaison to internal and external service resources, including communication and correspondence with referring agencies, vendors, and service partners.

·       Provide coordination of outside vendors, purchases, deliveries, etc…when asked.

EXPECTED PROFICIENCIES:

·       Adaptability with an enthusiastic and positive attitude

·       Excellent, professional, communication skills, including maintaining confidentiality and setting boundaries. 

·       Ability to use basic office and computer equipment, including single and multi-line telephones, copiers, scanners, facsimile machines.

·       Ability to produce, distribute, organize, file, and store documents (paper and electronic).

·       Competency in data entry and ability to work with a web-based database.

·       Customer service and problem-solving approach and skills as demonstrated through patience, tolerance, tact, diplomacy, and flexibility in all situations.

·       Well organized and ability to effectively manage multiple assignments to meet project deadlines.

·       Demonstrates accuracy and thoroughness, monitors own work to ensure quality and applies feedback to improve performance.

·       Familiar with and able to use Office Ally or any other medical billing portal

·       Familiar with Partnership Health Plan, Kaiser Permanente, Sutter Health and North Bay Health providers

·       Have a clear understanding of Community Supports Services and Enhanced Care Management

MINUIMUM QUALIFICATIONS:

·       Experience that demonstrates a capacity to provide support to managers and staff in various administrative duties as well as special projects.

·       Experience with CalAIM, Medi-Cal, or other healthcare billing processes, including claims submission, billing documentation, and use of billing portals, preferred.

·       Skilled in Microsoft Office Outlook, Word, Excel and Adobe programs.

·       Access to reliable personal transportation required, including a DMV record that permits driver to be insured under SHELTER, Inc.’s automobile coverage.

·       Must successfully pass a criminal background check.

·       Type at a minimum of 35 words per minute.

PREFERRED QUALIFICATIONS:

·       Associates degree in administrative services or related area, and/or certification from a two year program in related area.

·       Experience with Yardi, HMIS, Intacct, Rippling, and Office Ally.

·       Experience working with low income and/or homeless populations.

·       Experience working in diverse settings with people across all socio-economic spectrums and a wide variety of personalities and roles - staff, residents, local agencies, contractors, lenders, etc.

·       Bilingual English/Spanish

PHYSICAL DEMANDS:

The physical demands described below 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.