Medical Billing Specialist

Special Service for Groups - Alliance; California; On-site; USD 32,000 - 41,000; Full time

Benefits offered by this job

401(k)

Dental insurance

Employee assistance program

Flexible spending account

Health insurance

Life insurance

Paid time off

Retirement plan

Vision insurance

Job summary

DaMar Staffing is seeking a Medical Billing Specialist in California to manage the billing process, ensure accurate claims submission, and maintain compliance with health insurance policies.

The role requires knowledge of Medi-Cal, Medicare, private insurance, and experience with EMR systems. Strong attention to detail and analytical skills are essential for efficient revenue cycle management in a mental health setting.

Qualifications

• High School Diploma required; Bachelor's degree preferred.
• Medical Billing Certification strongly preferred.
• 1 year of direct service experience in hospital or mental health setting.

Responsibilities

• Provide assistance to program staff to update outcome data and create program reports.
• Assist in management of program Information System per DMH protocol.
• Review and analyze denied claims from LACDMH and other payers to identify root causes and resolution strategies.
• Track denied claims and troubleshoot billing issues.
• Monitor insurance status of clients and send monthly updates to DMH.
• Monitor provider status changes and report to DMH.
• Provide linkage with health facilities and support for providers/doctors.
• Support QA activities and staff onboarding in Exym and NAPPA.
• Resolve claims issues preventing invoicing and voided claims.

Skills

Attention to detail

Oral communication

Written communication

Interpersonal skills

Time management

Analytical skills

Problem solving

Education

High School Diploma

Bachelor's degree preferred

Medical Billing Certification

Tools

Exym

NAPPA

Quest lab systems

EMR

Job description

Job Title

Medical Billing Specialist

Job Summary

We are seeking a detail-oriented and customer-focused Medical Billing Specialist to join our mental healthcare team.In this role, you will be responsible for managing the billing process, ensuring accurate claims submission, and maintaining compliance with health insurance policies.The ideal candidate will possess strong knowledge of health insurance procedures, experience with electronic health record (EHR) systems, and a commitment to quality assurance.This position offers an opportunity to contribute to efficient revenue cycle management while providing excellent service to clients and insurance providers.

Duties

• Provide assistance to program staff to update outcome data and creating program reports
• Assist in the management of program Information System in accordance to DMH protocol.
• Review and analyze denied claims from LACDMH and other payers to identify root causes and resolution strategies.
• Track denied claims for denied codes and troubleshoot any billing issues with denied claims.
• Monitor insurance status of clients and send monthly updates to DMH.
• Monitor monthly change of provider status and send updates to DMH.
• Perform other tasks and responsibilities as assigned by the Program Director and/or Program Coordinator.
• Provide linkage with other health facilities (pharmacy, lab, medical offices, partners).
• Provide administrative support for program staff and managers as needed.
• Provide support for providers/doctors:scheduling, troubleshoot systems, QA related, and entering new clients into Quest lab systems.
• Provide support for QA team:compiling new blank charts, conducting an initial 25-Day QA Review and follow-up for new charts, uploading charts into EMR.
• Updating NAPPA of yearly Cultural Competency Trainings.
• Regularly update NAPPA on behalf of clinicians to maintain current and accurate information.
• Tracking yearly Cultural Competency Trainings for staff and maintaining training database.
• Creating accounts and setting up new staff in Exym and NAPPA.
• Updating staff professional licenses in Exym.
• Resolving claims with problems preventing invoicing and resolving voided claims.
• Resolving activities needing attention in Exym.

Minimum Qualifications - Knowledge, Skills and Abilities Required

High School Diploma.Bachelor's degree preferred.Medical Billing Certification One year of direct service experience in a hospital or mental health setting which has an interdisciplinary team approach.

Knowledge

Knowledge:Basic Computer software programs (Experience on Microsoft Word and Excel, Internet; Medi-cal, Medicare, private insurance, etc.) Skills:Good writing and oral (communication) skills are necessary; Strong interpersonal and social skills; Time management skills necessary; Strong analytical skills, problem solving abilities and sharp attention to detail Abilities:Ability to develop and maintain effective working relations with program and with community representatives and contractors; Ability to work both independently and as a member of a team.

Verification of Employment Eligibility and Background Check.

Pay:$23.00 - $30.00 per hour Expected hours:40.0 per week Benefits: 401(k) Dental insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Retirement plan Vision insurance Work Location:In person.