Senior Billing Specialist

The People Concern; California, Los Angeles (MO, CA); On-site; USD 60,000 - 80,000; Full time

Job summary

Join a forward-thinking organization as a Senior Billing Specialist, where you will play a crucial role in managing billing processes for mental health services. This position involves ensuring accurate and timely submissions of medical claims, collaborating with various departments, and maintaining compliance with local and federal regulations. You will utilize your expertise in billing procedures and electronic health records to support the mission of empowering vulnerable communities. If you are detail-oriented and passionate about making a difference, this role offers a rewarding opportunity to contribute to meaningful change.

Benefits

Medical Insurance

Vision Insurance

Dental Insurance

Retirement Planning (403b) & Matching

Paid Holidays

Paid Vacation Days

Paid Sick Days

Employee Assistance Plans (EAP)

Flexible Spending Account (FSA)

Corporate Discounts

Qualifications

• 3+ years of experience in DMH billing.
• Proficient in electronic health records and billing software.

Responsibilities

• Submit weekly billing to DMH and third-party payers.
• Manage denied claims and ensure compliance with regulations.

Skills

Billing Procedures

CPT Codes

Data Management

Communication Skills

Problem Solving

Education

High School Diploma or GED

Tools

EXYM

Microsoft Office (Excel, Outlook, Word)

Job description

Senior Billing Specialist

2116 Arlington Ave, Los Angeles, CA 90018, USA * Los Angeles, CA, USA
Req #11384

Wednesday, January 22, 2025

Title: Senior Billing Specialist
Reports to: Billing Manager

Department: Finance
Status: Full-Time; Non-Exempt (hourly); Non-Management

Location:Arlington Headquarters, 2116 Arlington Ave., Suite 100, Los Angeles, CA 90018

Schedule Monday-Friday (8:30AM-5:00pm)

Summary
The Senor Billing Specialist will review and verify that client records are complete for a successful transmission of medical claims for reimbursement from Department of Mental Health and private third-party providers. The Billing Specialist is responsible for ensuring that information is processed accurately and timely, and is Familiar with concepts, practices, and procedures for all billing claims to Department of Mental Health (DMH) using the Electronic Health Record (EHR) software EXYM.

Essential Duties and Responsibilities

1. Submit timely weekly billing to Los Angeles County Department of Mental Health and third-party payers using EHR, EXYM and Office Ally.


2. Collaborate with QA Department to oversee the electronic health record, EXYM; for billing, case closures, location, funding sources and productivity updates.


3. Review, manage and develop billing procedures as needed to maintain compliance with local, state and federal regulations.


4. Knowledge of use and application of Current Procedural Terminology (CPT) Codes.


5. Identify and notify management of denial patterns and issues.


6. Responsible for data tracking and reporting.


7. Manage, track and resolve denied and voided claims, following through until claim is paid.


8. Responsible for weekly download of SIFT Data. Review data for claim accuracy in DMH/IBHIS and EXYM systems.


9. Collaborate and consult effectively with Clinical Quality Assurance, Mental Health and any other staff/programs to ensure adherence to policies and procedures.


10. Generate and distribute statistical management reports to leadership, identifying unfiled, pending, denied, and submitted claims.


11. Responsible for maintaining the highest level of billing standards following current guidelines from Medi-Cal, and other insurance entities.


12. Understand how mental health staff in electronic databases (NAPPA, NPPES) affects billing accuracy and completion.


13. Check Medi-Cal eligibility on a bi-monthly basis for all clients and compile list of clients with terminated Medi-Cal as needed and provide management reports.


14. Attend internal and external meetings and trainings.


15. Perform a variety of general clerical duties; prepares a variety of routine correspondence, forms, reports and similar items using word processing and Excel Spreadsheet.


16. Develop and maintain claim resolution skills through continuous trainings, workshops and education.


17. Other duties as assigned.

Qualifications:

1. High school diploma or GED and a minimum of 3 years' recent experience in Los Angeles Department of Mental Health (DMH) billing.


2. Experience in Electronic Health Record EXYM preferred.


3. Knowledge of and expertise in third party payers and Medi-Cal billing.


4. Computer skills with strong proficiency in Microsoft Office Software (Excel, Outlook and Word).


5. Strong written and oral communication skills, presenting financial results to all relevant parties.


6. Excellent data management skills.


7. Able to be accurate, precise, and thorough and detail oriented.


8. Ability to perform mathematical and data processing tasks rapidly and accurately.


9. Demonstrates ability to handle multiple tasks simultaneously and to work independently.


10. A self-starter, with ability to coordinate multiple projects/tasks at once.


11. Possess problem solving and conflict resolution skills and exercises professional judgement.


12. Flexible, adaptable, and capable of working in a fast paced, professional environment.


13. Maintain and execute confidential information using HIPAA standards.


14. Covid-19 vaccinated and boosted or with a medical/religious exemption.

WORK ENVIRONMENT

1. Office environment.


2. Regularly required to sit, stand, bend; occasionally lift or carry up to 25 lbs.


3. On occasion walk or drive to different agency sites.


4. May necessitate working in busy and loud environments.


5. May be exposed to elements like cold, heat, dust, noise and odor.


6. May need to bend, stoop, twist, and sit throughout the day.

EXPECTED BEHAVIORS OF ALL STAFF

1. Act as a role model


2. Demonstrate a sense of responsibility


3. Continuously learn and improve


4. Acknowledge your own areas of improvement


5. Hear and provide honest, specific and direct feedback


6. Create an environment where everyone is welcomed valued and respected


7. Collaborate

Equal Opportunity Employer

The People Concern is an equal opportunity employer dedicated to non-discrimination in employment. We select the most qualified individual for the job basedon job-related qualifications regardless of race, color, age, sex, religion, national origin, disability, ancestry, marital status, credit history, sexual orientation, arrest and court record, genetic information, veteran status or any other status protected by federal, state or other applicable laws.

About the People Concern

The People Concern empowers the most vulnerable among us to rebuild their lives. One of Los Angeles County's largest social services agencies, The People Concern was formed in 2016 in a merger of two trusted social service organizations based in Los Angeles County, OPCC and Lamp Community. Informed by more than fifty-eight years of work in the community, The People Concern is a leading provider of, and advocate for, evidence-based solutions to the multi-faceted challenges inherent in homelessness and domestic violence.

With compassion and profound respect for those we serve, we provide a fully integrated system of care - including outreach, interim housing, mental and medical health care, substance abuse services, domestic violence services, life skills & wellness programs, and permanent supportive housing - tailored to the unique needs of homeless individuals, survivors of domestic violence, challenged youth, and others who have nowhere else to turn.

The People Concern's model of integrated and comprehensive care empowers our participants to navigate the multi-faceted obstacles in their lives, become their best selves, and ultimately, connect with and contribute to their communities.

Benefits & Perks

• Medical Insurance


• Vision Insurance


• Dental Insurance


• Retirement Planning (403b) & Matching


• Paid Holidays


• Paid Vacation Days


• Paid Sick Days


• Employee Assistance Plans (EAP)


• TELUS Health


• Flexible Spending Account (FSA)


• Basic Life / Accidental Death & Dismemberment (AD&D)


• Voluntary Short- and Long-Term Disability


• Voluntary Pet Insurance


• Discounts on Hotels, Theme Parks, Concerts, Movies, Restaurants & More


• The People Concern University & Certificates


• Corporate Discounts
  

Other details

• 
  Pay Type
  Hourly
  
• 
  Min Hiring Rate
  $23.56
  
• 
  Max Hiring Rate
  $25.97
  
• 
  Travel Required
  Yes
  
• 
  Required Education
  High School
  

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