Medi-cal Reimbursement Billing Specialist (41099)

HINDS HOSPICE•Fresno, CA

3d•$28 - $40•Onsite

About The Position

Hinds LifeCare, a well-respected nonprofit agency in California’s Central Valley and a pioneer in hospice and palliative care, is seeking a Medi-cal Billing Specialist. This role involves various tasks related to billing for patient care activities, including preparing claims, statements, and invoices for Medi-Cal, Medicare, and private insurance companies. The specialist will manage accounts receivable, ensure proper documentation, verify patient insurance coverage, and request authorizations. Key responsibilities include analyzing and resolving at least 45 claims daily, working to reduce accounts receivable to 90 days, correcting and resubmitting denied claims within 48 hours, submitting Notice of Election to Medicare and Medi-Cal payers, monitoring electronic claim billing processes, managing accounts receivable to improve cash flow, and submitting appeals as needed. The role also involves close collaboration with the Billing Manager on client collections and follow-ups, and staying current with billing regulations.

Requirements

High school diploma or general education degree (GED); or one-year related experience and/or training; or equivalent combination of education and experience.
Must be able to function autonomously with flexibility and confidence.
Ability to function in an interdisciplinary team setting.
Must possess good time management skills.
Demonstrate excellent communication skills.
Ability to deal with difficult and complex situations.
Demonstrated ability to function independently and with minimal supervision.
Possess the ability to establish and maintain positive, collegial working relationships with both administrative and clinical staff.
Proficiency in word processing and software programs.
Possess reliable automobile which may be used in the course of work.
Have a valid California driver’s license with acceptable driving record.
Proof of auto insurance and current auto registration.
Ability to meet the physical demands of the job (Push, Pull, Lift/Carry 10 lbs).

Nice To Haves

Bachelor’s degree in related field preferred.

Responsibilities

Prepares claims, statements, and invoices to be sent to Medi-Cal, Medicare and private insurance companies.
Manages accounts receivable.
Ensures proper documentation has been obtained.
Verify patient insurance coverage and benefits.
Request authorizations (and authorization extensions) as needed.
Analyze, correct and/or attempt to bring to resolution at least 45 claims daily.
Works towards reducing the total AR to only 90 days.
Correct and resubmit denied claims within 48 hours.
Submit hospice Notice of Election to Medicare and Medi-Cal payers.
Monitor insurance electronic claim billing process is completed successfully on a daily basis.
Monitor and manage accounts receivable to minimize overdue accounts and improve cash flow.
Submit appeals as needed.
Work closely with Billing Manager on client collections and conduct follow-ups on outstanding payments.
Stay current with changes to Medicare, Medi-Cal, and private insurance billing regulations, and conditions of payment.