Medical Billing & Coding Specialist

Victor Community Support Services; Barstow (CA); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Learning Organization

Leadership Development

Reimbursements

Loan Forgiveness

Low-cost Medical, Dental and Vision

Life Insurance

9 Paid Holidays, PTO and Sick pay

Retirement Savings Plan (403B)

Employee Assistance Program

Tuition Assistance

Employee Referral Bonus

Job summary

Victor is seeking a Medical Billing and Coding Specialist to manage claims for commercial health insurance plans and other contracts for new business lines.

The role reports to the Revenue Manager and involves collaboration with administrative staff to verify eligibility, process submissions, and pursue denials resolution. Experience with Waystar and a strong coding background are preferred.

Qualifications

• High School or equivalency degree with a minimum of four years of medical billing experience.
• Strong knowledge of coding requirements.
• Experience with Waystar software preferred.
• Must have knowledge of the English language.
• Must have knowledge of PC hardware and software operations and applications.

Responsibilities

• Collaborates with administrative staff to identify new referrals and potential new insurance plans monthly.
• Coordinates with administrative staff to ensure client eligibility and authorization for services as required by the insurance plan.
• Administration of claims submission and responses.
• Collaborates with Billing Associates to bill Medi-Cal as secondary insurance.
• Administers billing and collection activities for client copays, coinsurance, and deductible amounts.
• Monitors accounts receivable by commercial health insurance plan and initiates collection of overdue balances.
• Assists the Revenue Manager, administrative, quality improvement, and other staff in identifying and addressing the root causes of claim denials.
• Completes other duties as assigned.

Skills

Medical billing experience

Coding knowledge

English proficiency

Education

High School Diploma or GED

Tools

Waystar

Job description

• Learning Organization:Victor provides the best training for new grads and clinicians looking to begin their career!
• Leadership Development:Victor provides employees leadership training and promotes within! Many of our executive leadership team have been promoted from entry-level positions!
• Reimbursements:Victor provides reimbursements for license registration fees, CEUs, travel, internet/cell phone usage and more!
• Loan Forgiveness:Victor employees can apply for Public Service Loan Forgiveness!
• Low-cost Medical, Dental and Vision
• Life Insurance plan for employee and family
• 9 Paid Holidays, PTO and Sick pay
• Mental Health Day
• Retirement Savings Plan (403B)
• 100% Employer Funded Retirement Plan
• Employee Assistance Program
• Mileage Reimbursement
• Working Advantage Discount Program
• Verizon Wireless Discount
• Tuition Assistance
• Employee Referral Bonus Program

JOB SUMMARY

Under the supervision of the Revenue Manager, the Medical Billing and Coding Specialist is responsible for the administration of claims for services provided to clients with commercial health insurance plans and other contracts for new lines business.

ESSENTIAL FUNCTIONS

• Collaborates with administrative staff to identify new referrals and potential new insurance plans monthly.
• Coordinates with administrative staff to ensure client eligibility and authorization for services at the frequency required by the insurance plan.
• Administration of claims submission and responses.
• Collaborates with Billing Associates to bill Medi-Cal as secondary insurance.
• Administers billing and collection activities for client copays, coinsurance, and deductible amounts.
• Monitors accounts receivable by commercial health insurance plan and initiates collection of overdue balances.
• Assists the Revenue Manager, administrative, quality improvement, and other staff in identifying and addressing the root causes of claim denials.
• Completes other duties as assigned.

MINIMUM REQUIRED EDUCATION AND EXPERIENCE

• Must have a High School or equivalency degree and a minimum of four years of medical billing experience with an emphasis on commercial insurance providers.
• Strong knowledge of coding requirements.
• Experience with Waystar software preferred.
• Must have knowledge of the English language.
• Must have knowledge of PC hardware and software operations and applications.

POSITION/SITE REQUIREMENTS

• Must possess a valid California driver's license, personal automobile insurance, and driving record that meets the standards outlined in the Agency's Policy: Motor Vehicle Operating Standards.
• Must be physically and mentally fit in accordance with the Agency's Policy: Physical Fitness Standards and Examinations. Must be willing to complete a Tuberculosis (TB) test and drug screening test.
• Must be willing to complete a personal background investigation conducted by the State of California.
• Must be willing to complete a personal background investigation conducted by the State of California.
• Must be willing to work within a culturally integrated workplace and be willing to respect human differences based upon protected classes as defined by state, federal and local laws, or any other condition that distinguishes people from one another.

PHYSICAL REQUIREMENTS

• Have an adequate range of body motion and mobility to work in an office or outdoor environment including standing and walking (even and uneven surfaces), alternating between standing and sitting for extended periods of time, bending, kneeling, twisting, reaching balancing and occasional carrying and lifting up to 25 pounds occasionally, and up to 10 pounds frequently.
• Physically able to walk up and down stairs routinely.
• Must be able to sit for prolonged periods of time in a vehicle (may be up to 100 miles driving distance).
• Requires the ability to utilize computer and telephone systems, which includes the coordination of eye and hand and fine manipulation by the hands and fingers for typing, writing and working with files.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
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