HEALTH CARE BILLING CLERK II (1636) - DEPT. OF PUBLIC HEALTH - (H00077)

Sf Hrc; San Francisco (CA); On-site; USD 50,000 - 75,000; Full time

Job summary

The San Francisco Department of Public Health is seeking a Health Care Billing Clerk II to manage complex medical claims for patients. Applicants should have experience in billing and claims processing, with knowledge of Medicare, Medi-Cal, and insurance regulations. The role involves a range of billing duties and requires strong detail orientation and interpersonal skills.

Qualifications

• One year of experience in billing for healthcare services.
• Completion of relevant medical billing coursework can substitute experience.

Responsibilities

• Processes medical claims to various payors for reimbursement.
• Evaluates billing documents for accuracy and program compliance.
• Researches questions and provides assistance regarding claims.

Skills

Knowledge of medical terminology

Ability to perform detailed clerical work

Interpersonal relations

Ability to perform mathematical calculations

Ability to use a personal computer

Education

Completion of 15 semester units or 22 quarter units of medical billing

Job description

Health Care Billing Clerk II (1636) - Dept. of Public Health - (H00077)

Recruitment : REF41219Z

Published : July 12, 2024

Accepting applications until : July 12, 2024

Apply using SmartRecruiters, the City and County of San Francisco's application portal.

The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in its workforce. All employees at the Department of Public Health work to advance equity, inclusion, and diversity with a specific lens and focus on race, ethnicity, gender, sex, sexuality, disability, and immigration status.

The Mission of the San Francisco Department of Public Health (SFDPH) is to protect and promote the health of all San Franciscans. SFDPH strives to achieve its mission through the work of two main Divisions - the San Francisco Health Network and Population Health. The San Francisco Health Network is the Citys only complete system of care and has locations throughout the City, including Zuckerberg San Francisco General Hospital and Trauma Center, Laguna Honda Hospital and Rehabilitation Center, and over 15 primary care health centers.

Under general supervision, the 1636 Health Care Billing Clerk II processes difficult and complex medical claims to Medicare, Medi-Cal, Commercial and third-party payers for services provided to patients by the Departments of Public Health. This classification is the journey-level class in the series responsible for performing the full range of duties.

The 1636 Health Care Billing Clerk II performs the following essential job functions :

• Processes bills and claims for services rendered to patients in order to obtain reimbursement from Medicare, Medi-Cal, commercial, and third-party payors based upon current governmental billing rules and regulations;
• Evaluates billing documents and claims data for accuracy, completeness, and program compliance;
• Prepares the initial claims and the follow-up claim if necessary by categorizing charges according to the types of medical services provided, completing medical information, verifying that all charges relate to the diagnosis and calculating the charges and benefits according to regulations;
• Spends down Medi-Cal share of cost in order to certify monthly coverage to allow processing of claims;
• Posts payments received from various payors, including Medicare, Medi-Cal, commercial, and third-party payors;
• Sends Claims Inquiry Forms (CIFs), appeals, and tracers on unpaid accounts at predetermined intervals;
• Researches questions and denials and provides assistance to patients, physicians, insurance and legal representatives, fiscal intermediaries and others regarding claims reimbursement and coverage;
• Produces reports relevant to billing and claims activities using electronic databases.

The 1636 Health Care Billing Clerk II also performs other related duties as required.

How to qualify

Minimum Qualifications - Required

EXPERIENCE : One (1) year of experience billing, claims processing and / or collecting healthcare services reimbursements or medical claims from Medi-Cal (Medicaid), Medicare, insurance, third party payors, and individual payors in a hospital, healthcare agency, or healthcare billing organization.

Substitution : Completion of 15 semester units or 22 quarter units of medical billing related coursework from an accredited college or university may substitute for six (6) months of qualifying experience.

Applicants must meet the minimum qualification requirement by the final filing date unless otherwise noted.

Important Note : Please make sure it is absolutely clear in your application exactly how you meet the minimum qualifications. Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. Please be aware that any misrepresentation of this information may disqualify you from this recruitment or future job opportunities.

Selection Procedures :

After application submission, candidates deemed qualified must complete all subsequent steps to advance in this selection process, which includes the following :

Minimum Qualification Supplemental Questionnaire (MQSQ) (Weight : Qualifying) : Candidates will be required to complete an MQSQ as part of the employment application. This MQSQ is designed to obtain specific information regarding an applicant's experience in relation to the Minimum Qualifications (MQ) for this position. The MQSQ will be used to evaluate if the applicant possesses the required minimum qualifications.

Assessment Component

Candidates that meet the minimum qualifications will be invited to participate in a written multiple-choice exam that is designed to measure the knowledge, skills, and abilities in job related areas which may include but not be limited to :

• Knowledge of medical claim data collection, billing, and processing for reimbursement from Medicare, Medi-Cal, commercial, and third-party payers
• Knowledge of basic medical terminology
• Knowledge of modern office practices and procedures
• Knowledge of payment posting procedures
• Ability to perform detailed clerical work in a methodical and thorough manner with accuracy
• Ability to read and analyze a medical chart. Ability to read and understand information and ideas presented in writing
• Interpersonal relations ability
• Ability to perform mathematical calculations accurately and effectively
• Ability to use a personal computer to enter and update data, create documents, and use system applications, email, spreadsheets, and word-processing software
• Knowledge of Medicare and Medi-Cal rules and regulations, including Short-Doyle Medi-Cal system

Written Examination (Weight : 100%) : Candidates must achieve a passing score on the written multiple-choice exam in order to continue in the selection process and will be placed on the confidential eligible list in rank order according to their final score.

Additional selection processes may be conducted by the hiring department prior to making final hiring decisions.

NOTE : Qualified applicants will receive an email notifying them of the examination's exact time and location. If you also apply and meet the minimum qualifications for the 1635 Health Care Billing Clerk I recruitment, you will only be scheduled for the examination once. Your score will then be applied to both recruitments.

Certification

The certification rule for the eligible list resulting from this examination will be the Rule of 3 Scores.

The duration of the eligible list resulting from this examination process will be 12 months and may be extended with the approval of the Human Resources Director.

What else should I know?

How to apply :

Applications for City and County of San Francisco jobs are only accepted through an online process. Visit careers.sf.gov and begin the application process.

Applicants may be contacted by email about this recruitment therefore, it is their responsibility to contact the Analyst if they update their email address.

Applicants will receive a confirmation email that their online application has been received in response to every announcement for which they file. Applicants should retain this confirmation email for their records. Failure to receive this email means that the online application was not submitted or received.

Terms of Announcement and Appeal Rights :

Applicants must be guided solely by the provisions of this announcement, including requirements, time periods and other particulars, except when superseded by federal, state, or local laws, rules or regulations.

Additional information regarding Employment with the City and County of San Francisco :

If you have any questions regarding this recruitment or application process, please contact the analyst, Herbert Chau at [emailprotected] or [phone] .

We may use text messaging to communicate with you on the phone number provided in your application. The first message will ask you to opt in to text messaging.

CONDITION OF EMPLOYMENT : All City and County of San Francisco employees are required to be fully vaccinated against COVID-19 as a condition of employment. Someone is fully vaccinated when 14 days have passed since they received the final dose of a two-shot vaccine or a dose of a one-shot vaccine. Any new hire must present proof of full vaccination status to be appointed. Any new hire who will be routinely assigned or occasionally enter High-Risk Settings must provide proof of having received a COVID-19 booster vaccine by March 1, 2022, or once eligible.

The City and County of San Francisco encourages women, minorities and persons with disabilities to apply. Applicants will be considered regardless of their sex, race, age, religion, color, national origin, ancestry, physical disability, mental disability, medical condition (associated with cancer, a history of cancer, or genetic characteristics), HIV / AIDS status, genetic information, marital status, sexual orientation, gender, gender identity, gender expression, military and veteran status, or other protected category under the law.

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Billing Clerk • San Francisco, CA, United States