Billing Specialist II

Tuolumne Me Wuk Indian Health Center Inc.•Sonora, CA

6d•$28 - $42•Onsite

About The Position

Join our team at the Tuolumne Me-Wuk Indian Health Center, where we offer more than just a job -- we provide a community-focused environment with competitive salaries, exceptional benefits, and a true work-life balance. Our comprehensive benefits package includes medical, dental, vision, and a 401(k) plan, ensuring you and your family are well cared for. Plus, take advantage of Indian Health Service Loan Forgiveness opportunities to advance your career while reducing your student debt. Located in the heart of California’s Sierra Nevada foothills, our location offers not just a fulfilling career but the chance to explore a region full of stunning landscapes and outdoor recreation. Spend your days helping others grow professionally and your evenings and weekends hiking through serene mountain trails, kayaking on pristine lakes, or enjoying the charm of historic Downtown Sonora. With its vibrant culture, unique shops, and year-round festivals, you’ll find endless ways to connect and thrive. Whether you’re seeking professional growth or outdoor excitement, Tuolumne County is the perfect place to build your future. Apply today and start your next adventure with us! POSITION OVERVIEW: Title: Billing Specialist II Reports To: Billing Manager Schedule: M-F; 8am-5pm Status: Non-Exempt Summary: The Billing Specialist II role is an intermediate-level position and is responsible for processing of all encounters to ensure compliance with federal, state and payer specific guidelines. Provide the Billing Manager with monthly reports on the status of all third-party payor's activity including delinquent accounts, aging report of all accounts, and recommended write-off of accounts. Adherence to protocols will be in accordance with HIPAA regulation requirements.

Requirements

High school diploma or GED.
3-4 years of work experience in healthcare billing.
Must have knowledge of Medi-Cal terminology and ICD 10/CPT Medi-Cal coding.
Knowledge of all insurance billing procedures and guidelines including Medicare, Medi-Cal, private insurance.
Experience with and the ability to operate Microsoft Office software is required.
Must possess sufficient written and verbal communication skills to be able to interact with Medi-Cal professionals, patients and peers in a professional manner.
Excellent customer service skills, including good communication and strong interpersonal skills.
Must have the ability to work in a fast-paced and sometimes stressful environment.
Must have the ability to work in an independent and self-directed manner and assume individual responsibility.
Must have a general knowledge of and ability to maintain HIPAA privacy requirements and sign a confidentiality agreement.

Nice To Haves

Medi-Cal Billing Certificate preferred.
Optometry and Dental billing experience a plus.
Experience working multiple EHR software systems is preferred.

Responsibilities

Responsible for billing appropriate payors for services rendered by the Medi-Cal, dental, optometry, behavioral health or physical therapy staff.
Maintains accountability and accuracy of all ICD 10/CPT coding guidelines.
Oversees all investigations on missing ICD 10/CPT coding and works with the coding team to ensure proper documentation and reimbursement.
Responsible for conducting and completing all necessary patient and insurance inquiries, appeals and refunds.
Ensure compliance with federal, state and payer-specific guidelines.
Electronically sends insurance claims on a regular basis and follows up on claims to ensure proper adjudication.
Analyzes and summarizes all types of insurance denials and reports any unusual findings to the Billing Manager.
Train and assist Billing Specialist I staff as needed.
Must have the ability to work in an independent and self-directed manner and assume individual initiative.
Be familiar with the aims and objectives of the Health Center and express a genuine enthusiasm for its success.
Regular and consistent attendance is an essential function of this position.
Performs other duties as assigned.