Billing Specialist

Seneca Family of Agencies•., CA

3d•Remote

About The Position

The Billing Specialist is responsible for ensuring the accurate and efficient processing of billing and reimbursement for services provided in assigned programs and regions. This role involves preparing, submitting, and tracking insurance claims, as well as reconciling payments to ensure timely and accurate reimbursement from payers. The Billing Specialist also serves as a key point of contact for addressing billing-related inquiries, fostering transparency, and understanding in the billing process. The Billing Specialist will be supporting multiple programs: Unconditional Education (UE) Outpatient (OP), UE Mosaic, UE Constellation, UE Ala Pathways Medical. Seneca’s Unconditional Education Rooted to Rise Program partners with Oakland Unified School District to provide therapeutic and behavioral intervention services for children and families in critical need of support, resources and care. Our Medi-Cal funded program provides individual, family and group therapy as well as push-in behavioral intervention and social skills development during the school day to students. Our team integrates into the school community, collaborates with school partners to deliver interventions and services needed for students to thrive. Seneca Family of Agencies has been nominated among the Bay Area’s Top Workplaces for nearly a decade. We’re committed to providing traditionally marginalized communities with a network of outstanding mental health, community-based, and educational services. We are committed to building a diverse staff, and our programs actively engage in conversations and training on Diversity, Equity, and Inclusion to promote equity and justice for the youth and families we serve.

Requirements

Bachelor’s degree OR Associate degree + 1 year of applicable work experience OR High school diploma/GED + 2 years of applicable work experience. Applicable work experience includes relevant experience in data entry, claims processing, and revenue cycle billing.
Familiar with most Medical Insurance Payors including Medi-Cal and commercial insurance preferred.
Strong computer skills with a high level of proficiency in Excel.
Demonstrated organizational, analytical and problem-solving skills with the ability to move issues forward to resolution.
Extremely detail oriented with strong skills in organizing, tracking, and maintaining large amounts of information.
At least 21 years of age.
TB test clearance, fingerprinting clearance, and any other state/federal licensing or certification requirements.

Responsibilities

Prepare and submit accurate claims, invoices and required documentation for services, including coding diagnoses and procedure codes.
Monitor and track claims to ensure timely submission and investigate and resolve billing inaccuracies and billing related issues.
Check eligibility and benefit verification to determine client’s eligibility and if additional private health insurance exists for each client.
Collaborate with funders and insurance companies to resolve billing inconsistencies and errors.
Communicate with program and QA staff regarding any changes to a client’s eligibility.
Bill and collect copays/deductibles from parents/guardians in applicable programs.
Upload files to respective systems to apply payments and adjustments and provide reports from the electronic health record system.
Review billing denial queues and billing-related reports on a daily basis to ensure the timely processing of claims and denials. Resubmit claims as needed.
Communicate with program staff regarding corrections or necessary changes in documentation.
Input, complete, and review billing and payment invoices using internal and external Electronic Health Record (EHR) and Clearinghouse systems for assigned program(s) and submit reports in a timely manner.
Maintain proper documentation for each claim, including relating to the approval or denial of claims, utilizing the appropriate county forms and systems.
Reconcile payments and resolve discrepancies. Work with payers to appeal and correct errors.
Stay up to date on changes in billing codes, regulations, and payer policies.
Attend all required trainings and meetings.

Benefits

Starting at $28.41 - $30.91 per hour
Actual salary is dependent on creditable experience above the minimum qualifications for the role
Salary increases each year
5 weeks of Paid Time off and 11 Paid Holidays
Comprehensive benefits package:
Medical, dental, vision, chiropractic, acupuncture, and fertility coverage
50% paid premiums for dependents
Long-term disability, family leave, and life insurance
403b Retirement Plan
Employer-paid Employee Assistance Plan
Scholarship opportunities, ongoing training, and professional development opportunities
Seneca is a Public Service Loan Forgiveness certified employer
Promotional opportunities across the agency in California and Washington