Billing Specialist II

JOB SUMMARY:
Under the direction of the Quality Assurance Manager, the Billing Specialist oversees all aspects of billing entry and report accuracy for Medi-Cal, Cal WORKS, and other funding streams. The position also oversees administrative contract requirements as assigned and supports the quality assurance department tasks as needed.

The Billing Specialist communicates with Program Managers and direct service staff to implement best practices regarding billing documentation and compliance. The Billing Specialist is responsible for communicating collaboratively, respectfully, and effectively with colleagues from diverse backgrounds.

_ Important: This position is hybrid and requires you to be in the office twice a week._

DUTIES AND RESPONSIBILITIES:

• Input billing into the statewide billing system known as SmartCare and other funder systems as assigned
• Audit billing entries, process report crosschecks, and ensure the accuracy of other billing staff data entry
• Processes client registration, case openings, closings, and updates in the statewide billing system (SmartCare) and communicates with clinicians and program managers as needed to ensure accuracy and timely completion of these tasks
• Manages and utilizes county reports to ensure compliance, including denials, ineligibility, out-of-county (Alameda County) medical, annual authorization approvals, SSN, and Zip 4
• Attends billing-related county meetings and training and communicates with Alameda County Behavioral Health (ACBH) as needed, informing the Quality Assurance Manager of any changes in expectations
• With the support of the Quality Assurance Manager, oversees the annual renewal of confidentiality statements and compliance for Alameda County
• Monitors county contract reporting requirements, including obtaining staff numbers and other reporting needs as assigned
• Research cost report discrepancies and report back to Finance and Executive Directors regarding findings that impact agency budgets
• Participates in State and County audit preparation as needed
• Meets regularly with Quality Assurance staff and supports team functions

OTHER JOB FUNCTIONS:

• Attends all staff, QA department, and other mandatory meetings and designated training events sponsored or required by Family Paths
• Participates in State Audit preparation as needed
• Provides data for reports and contracts as needed
• Supports staff with documentation and billing questions, as needed
• Performs related duties as required

QUALIFICATIONS - REQUIRED:

• Knowledge of medical billing practices
• Experienced with MS Word, Excel, and Electronic Health Records (EHR)
• High School Graduate or GED
• Minimum of 3 years of data-entry experience
• High attention to detail
• Ability to work independently
• Ability to multi-task
• Excellent written and verbal communication skills
• Ability to prioritize workflow and adhere to strict deadlines

QUALIFICATIONS - PREFERED:

• Knowledge of Alameda County Medi-Cal billing practices.
• Undergraduate degree

SPECIAL REQUIREMENTS

• Must pass criminal records clearance
• Be able to conduct some driving on agency business time. Therefore, you must maintain a valid CA driver’s license, a reliable personal automobile, a clean driving record, and your current personal auto insurance to meet the required limits of liability
• Be able to competitively navigate Family Paths’ Electronic Health Records database and the California billing system known as SmartCare
• Be able to identify discrepancies between the platforms used and research ways to make necessary amends according to data entry guidelines from the provided manuals and the QA manager’s instructions
• Be able to enter data accurately and have ways to double-check it efficiently
• Ability to adapt documentation standards that meet various contract/funding requirements
• Ability to communicate effectively and respectfully (both verbally and in writing) to colleagues from diverse backgrounds
• Must demonstrate an acceptable level of good judgment and the ability to maintain a high level of discretion and confidentiality
• Displays a professional demeanor and "can do" attitude to represent the organization positively
• Has outstanding interpersonal skills, works effectively in a team, and works effectively and maintains composure in a stressful or deadline-driven environment
• Is adaptable and a proactive problem solver. Has the ability and willingness to do what it takes to contribute to their own success and the agency's success

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

• Occasionally required to stand
• Occasionally required to walk
• Frequently required to sit
• Frequently required to utilize hand and finger dexterity
• Occasionally required to climb, balance, bend, stoop, kneel, or crawl
• Frequently required to talk or hear
• While performing the duties of this job, the noise level in the work environment is usually moderate
• The employee must occasionally lift and/or move up to 25 pounds
• Specific vision abilities required by this job include close vision (on a computer or reading documents)

The above is intended to describe the general content of and requirements for this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Job Type: Full-time

Pay: From $25.75 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance

Schedule:

• Monday to Friday
• No nights
• No weekends

Work setting:

• Hybrid work

Ability to Relocate:

• Oakland, CA 94612: Relocate before starting work (Required)

Work Location: Hybrid remote in Oakland, CA 94612

Salary : $26