Intake and Billing Specialist

OVERVIEW:

The Intake and Billing Specialist, will be responsible for ensuring pre-authorization for client intake and for submitting billing to Managed Care Plan Providers for services provided under the CalAim Short Term Post-Hospitalization Housing Program.

DUTIES AND RESPONSIBILITIES:

• Establish and obtain pre-authorization for client eligibility prior to intake into the program using the Medi-Cal's TAR (Treatment Authorization Form) and maintain authorizations for each patient
• Accounts Receivable billing and collection from Managed Care Plan Providers
• Complete the intake of clients into the program including required documentation as directed
• Medi Cal coding for all reimbursable medical services received following program procedures
• Input of medical billing codes for claims into medical billing software in a timely manner meeting submission timelines
• Assist with resolving questions and/or problems with billing
• Follow-up with billings and claims
• Reconciliation and auditing of accounts receivable
• Reviews and verifies accuracy, completeness, and integrity of claims
• Maintains files for the Post-Hospitalization Program
• Other related duties as required

EDUCATION AND EXPERIENCE:

• High school diploma or equivalent (required)
• 18 years old (required)
• Education and /or experience in medical billing, especially Medi Cal billing and medical billing software
• Medical terminology course passed with at least a "C" in the past 5 years (preferred)
• Experience with disadvantaged populations, whether through work, volunteering is helpful

SKILLS AND ABILITIES:

• Typing of 35 words per minute
• 10-key and data entry skills
• Intermediate skills in Microsoft software to include Word, Excel, PowerPoint and Access
• Ability to prioritize work and multi-task simultaneous tasks
• Ability to communicate effectively and accurately
• Have good social interaction skills

PHYSICAL REQUIREMENTS:

• Ability to lift up to 25 lbs. (usually file boxes)

EQUIPMENT USED:

• Modern Office Equipment and Relevant Software