Billing and Coding Analyst - Surgical Subspecialty Clinic

Ventura County; Ventura (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

Ventura County Health Care Agency is seeking a Billing and Coding Analyst to support the Ambulatory Care Clinic System, covering ENT, plastic reconstruction, neurology, and urology. The role bridges medical billing and coder-certified functions and requires professional coding experience plus relevant credentials.

The ideal candidate will train staff and contribute to audits. Open positions include regular full-time vacancies with opportunities for advancement and educational incentives based on

Qualifications

• Seven (7) years of hands-on working knowledge and experience performing professional medical coding and/or billing duties in a medical system similar to Ventura County Health Care Agency.
• Associate or Bachelor's degree in a business-related field preferred.

Responsibilities

• Review electronic medical records for accuracy of diagnosis, procedure codes, and modifiers per billing guidelines.
• Monitor work queues and review claim errors to ensure timely resolution.
• Analyze and validate medical records to ensure correct code selections; prepare educational materials for providers.
• Perform edit checks on data prior to transmittal and correct errors using standard reporting.
• Ensure accurately coded data is integrated into the billing process; collaborate with billing staff to identify trends.
• Conduct provider and staff training on billing guidelines; audit work of non-facility coders.
• Review denials, registrations errors, missing authorizations, and educate staff to prevent future issues.
• May be assigned multiple locations to ensure timely completion of reporting and billing activities.
• Review applications, registration and billing for compliance with sliding fee discount program.
• Participate in audit resolution and corrective action activities.
• Other related duties as assigned.

Education

Seven years of medical coding and/or billing experience

Associate or Bachelor's degree in business-related field

Job description

THE POSITION:

Under general direction this position is responsible for providing billing and coding support within the Ambulatory Care Clinic System. The clinic areas of specialization include ENT, plastic reconstruction, neurology, and urology.

Distinguishing Characteristics:

This classification is a bridge between the Medical Billing Specialist series and the Coder-Certified classification. It differs from the Coder-Certified classification in that the former is responsible for reviewing the accuracy of billing codes which have been entered by providers into our billing system and the latter is responsible for reviewing provider notes in patient’s charts to determine the correct billing code and entering into our billing system.

AGENCY/DEPARTMENT:

Health Care Agency - Ambulatory Care

EDUCATIONAL/BILINGUAL INCENTIVE:

Some positions may be eligible for educational incentive. This incentive may be 2.5%, 3.5%, or 5% for incumbents in eligible positions based on completion of an Associate's, Bachelor's, or Master's degree that is not required for the classification. Incumbents may also be eligible for bilingual incentive depending upon operational need and certification of skill. Billing and Coding Analysts are represented by SEIU and are not eligible for overtime compensation.

The eligible list established from this recruitment will be used to fill current and future Regular (including Temporary and Fixed-term), Intermittent, and Extra Help vacancies for this position only. There is currently one (1) regular full-time vacancy.

TENTATIVE SCHEDULE

OPENING DATE: March 23, 2026

CLOSING DATE: Continuous (Previously: April 3, 2026)

Duties may include but are not limited to the following:

• Reviews electronic medical records initiated by a health care provider and ensures accuracy of diagnosis, procedure codes, and modifiers in accordance with Federal and State regulations in compliance with billing and coding guidelines.
• Effectively monitors assigned work queues and reviews claim errors, ensuring timely and accurate resolution of accounts.
• Review, Analyze and validate medical records to ensure completeness and accuracy of code selections while identifying educational opportunities. Prepares educational materials to communicate with providers when identifying gaps in clinical documentation for the selection of appropriate diagnosis, procedure and modifiers
• Performs edit checks on data entered prior to transmittal and correct errors as indicated by using our standard reporting such as discharged, not final billed (DNFB) Correction Required, Late Charges, Suspended Charges, Encounters with and without charges, and Past Due Arrival or other specialized reporting including Eligibility.
• Ensures accurately coded data is integrated properly into the billing process timely while developing efficient workflows and streamlining the reimbursement. Collaborate with the billing staff to identify trends and improvement opportunities.
• Conducts provider and staff training and on-going education on billing guidelines and audits the work of non-facility coders. Remains current with regulatory guidelines for billing and coding including health plans and coding updates.
• Review and Analyze denials, rejected claims, registration errors, missing authorizations and compiles training materials to educate the support staff for denial prevention and unnecessary claims rework.
• May be assigned multiple locations to ensure accurate and timely completion of assigned reporting and billing activities.
• Reviews application forms, supporting documentation, registration and billing for compliance with the sliding fee discount program.
• Participates in audit resolution, implementation and oversight of corrective action activities.
• Performs other related duties as assigned.

These are entrance requirements to the examination process and assure neither continuance in the process nor placement on an eligible list.

EDUCATION, TRAINING, AND EXPERIENCE:

Any combination of education and experience which has led to the acquisition of the required knowledge, skills, and abilities. The required knowledge, skills, and abilities can typically be obtained by:

• Seven (7) years of hands-on working knowledge and experience performing professional medical coding and/or billing duties in a medical system comparable to the Ventura County Medical Center or an outpatient clinic providing high volume surgical specialty services similar to the Ventura County Ambulatory Care clinics.

NECESSARY SPECIAL REQUIREMENTS:

• Previous paid, professional billing and coding experience working in a surgical environment.
• Must possess and maintain at least one of the following:
  • Certified Coding Specialist (CCS)
  • Certified Professional Coder (CPC) as credentialed by the American Academy of Professional Coders (AAPC)
  • Certified Coding Specialist-Physician (CCS-P) as credentialed by the American Health Information Management Association (AHIMA).

DESIRED:

• An associate or bachelor's degree in a business-related field.

Knowledge, Skills, and Abilities:

Thorough knowledge of: common surgical specialties such as otolaryngology (ENT), plastic reconstruction, urology and neurology; surgical terminology; operative report structures related to surgery; medical reimbursement programs and complexity of payment systems; Current Procedural Terminology Codes (CPT) codes, International Classification for Diseases (ICD)-10 codes, Health Care Procedure Coding System (HCPCS) codes for payment processing of Medicare and/or Medi-Cal; Medi-Cal Provider Manual for Billing and Policy and Program and Eligibility; the Treatment Authorization Request (TAR) process; authorization requirements and processes of private health plans (such as Blue Cross/Blue Shield and Healthnet) and the Ventura County Health Care Plan.

Ability to: interpret operative reports and surgical documentation; demonstrate open and direct communication with peers, managers, patients, and payers; review accounts for appropriate documentation, coding and billing information; evaluate and identify compliance and audit issues and work progressively with the compliance office to identify and resolve regulatory conflicts.

FINAL FILING DATE:

This is a continuous recruitment and may close at any time. Your application must be received by County of Ventura Human Resources Health Care Agency no later than 5:00 p.m. on the closing date.

(Previously: Applications must be received by County of Ventura Human Resources in Ventura, California, no later than 5:00 p.m. on April 3, 2026).

EQUAL EMPLOYMENT OPPORTUNITY:

The County of Ventura is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding, and related medical conditions), and sexual orientation.