CalAIM Billing Specialist

Fresno Rescue Mission Inc•Fresno, CA

About The Position

CalAIM Billing Specialist will manage the day-to-day administrative operations of The Fresno Mission by playing a vital role in the CalAIM CS and ECM billing cycle. In addition, the Billing Specialist will also provide CalAIM-specialized billing services along with other billing duties and administrative support. Who you are: Someone who recognizes the value of other people regardless of their choices. Attentive with a listening ear and desire to give respect and time to our clients and guests. A good example of who Christ is and willing to share how He saved you from yourself. Dependable and trustworthy with sensitive and personal information. Fair in situations and able to determine what is just and equitable in difficult situations. Gentle in character and able to be calm and tender when others are challenging. Generous in heart, empathy, patient, and humble. Someone who brings excellence to everything you do. Able to work in a fast-paced and constantly changing environment. Great at time management.

Requirements

High school diploma or equivalent.
Understanding of medical billing codes, insurance reimbursement processes, and relevant state and federal regulations.
Knowledge of financial software and billing systems, particularly those used in healthcare.
Strong attention to detail and accuracy in data entry and financial reporting.
Excellent organizational skills and the ability to manage multiple tasks efficiently.
Proficiency in Microsoft Office Suite, particularly Excel, and billing software applications.
Capacity to recognize and identify billing discrepancies to resolve issues efficiently.
Strong written and verbal communication skills (English).
Thorough understanding of billing requirements and updates to ensure compliance.
Ability to coordinate with internal operations, such as program managers and service providers to ensure accurate billing for services rendered.
Willingness to establish strong lines of communication with insurance companies and other billing entities to facilitate prompt payment.
Capacity to administer regular, internal audits of billing records to identify discrepancies and areas for improvement.
A mature walk with Jesus Christ and able to articulate Biblical beliefs and their application within the context of the Fresno Mission. All employees of Fresno Mission are an integral part of the outreach ministry of a non-denominational, evangelical ministry sharing the Gospel of Jesus Christ through transformational programs that provide food, shelter, clothing, education, job training and renewal of families to the poor and addicted. All employees are Christian missionaries and are required from time to time to participate in chapel services, outreach ministries, Bible studies and prayer times. Due to the nature of these types of ministries, it is an absolute necessity that each employee possesses and maintain a Christian testimony of their faith and experience in Jesus. Must be in agreement with the Statement of Faith of the Fresno Mission.

Nice To Haves

You have the flexibility to adapt to changes and take on new responsibilities as the organization grows.
Puedes hablar, leer y escribir en espanol.
You’re excited to work in a fun fast-paced atmosphere where everyone takes the mission seriously, but no one takes themselves too seriously.

Responsibilities

Submits invoices to the Managed Care Plan (MCP) for multiple CS and ECM rendered on a single day for a single client/guest/member.
Submit claims for the provision of CS and ECM-related services to MCPs using the national standard specifications and code sets to be defined by DHCS.
Collaborate with other departments to obtain and analyze additional information about clients/guests/members to be able to record and process billing effectively.
Ensures that maximum reimbursement is obtained through billing and coding of all services rendered.
Responsible for correcting, completing, and processing claims of all respective payer codes.
Daily monitoring of assigned queues for claim progression directly impacting timely payments
Manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, and insurance inquiries/correspondence.
Prepares and submits clean claims to third-party payers either electronically or by paper per the payor guidelines.
Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
Contributes to every stage of the revenue cycle, from claim submission to denial management, to payment posting review and reporting.
Prepare, review, and transmit claims using billing software, including electronic and paper claim processing with timely claim submission
Prepares and keeps an organized filing system for all program documents related to billing. Submit monthly reports of billing activities and developments to the CEO and Director.
Attends weekly team meetings.
Other duties and responsibilities as required by the CalAIM Director.