Medical Billing Program Specialist II

SHELTER, Inc. • Fairfield, CA

3d • $24 - $30 • Onsite

About The Position

The Medical Billing Program Specialist II prioritizes and manages medical and CalAIM billing for the campus. The role tracks services, communicates about provided services, and prepares and submits billing. It also provides administrative support to programs and staff, including clerical tasks such as answering and returning calls, managing files and documents, assisting with participant information, entering data into systems, and collecting documentation. The position may also support intakes.

The specialist responds to inquiries, maintains accurate data and records, supports billing compliance, and assists with client screenings, eligibility checks, appointment scheduling, audits, reports, and program coordination. The role may involve liaising with internal and external service resources, coordinating vendors and purchases, participating in assigned service trainings, and providing backup coverage for certain positions.

Requirements

• Experience demonstrating the capacity to support managers and staff with varied administrative duties and special projects.
• Proficiency with Microsoft Outlook, Word, Excel, and Adobe programs.
• Reliable personal transportation and a DMV record that allows the employee to be insured under SHELTER, Inc.'s automobile coverage.
• Successful completion of a criminal background check.
• Typing speed of at least 35 words per minute.
• Ability to use basic office and computer equipment, including single- and multi-line telephones, copiers, scanners, and fax machines.
• Ability to produce, distribute, organize, file, and store paper and electronic documents.
• Competency in data entry and ability to work with a web-based database.
• Professional communication skills, including maintaining confidentiality and setting boundaries.
• Customer service and problem-solving skills demonstrated through patience, tolerance, tact, diplomacy, and flexibility.
• Organization and ability to manage multiple assignments and meet deadlines.
• Accuracy and thoroughness, with the ability to monitor work quality and apply feedback.
• Adaptability and an enthusiastic, positive attitude.
• Familiarity with Office Ally or another medical billing portal, Partnership Health Plan, Kaiser Permanente, Sutter Health, and North Bay Health providers, and a clear understanding of Community Supports Services and Enhanced Care Management.

Nice To Haves

• Experience with CalAIM, Medi-Cal, or other healthcare billing processes, including claims submission, billing documentation, and billing portals.
• Associate degree in administrative services or a related area, and/or certification from a two-year program in a related area.
• Experience with Yardi, HMIS, Intacct, Rippling, and Office Ally.
• Experience working with low-income and/or homeless populations.
• Experience working in diverse settings with people across socioeconomic spectrums and a variety of personalities and roles.
• Bilingual English/Spanish.

Responsibilities

• Respond promptly, accurately, and professionally to calls and emails, providing high-quality customer service.
• Track and document billable services; prepare, submit, and monitor CalAIM/Medi-Cal claims; check claims for accuracy and completeness; research and resolve denied or rejected claims; maintain billing documentation and records; and prepare billing reports.
• Support intakes by assisting with client screenings, intake paperwork, eligibility verification, appointment scheduling, and record maintenance.
• Prepare, distribute, and file correspondence, notices, invitations, reports, and other documents.
• Assist with program, client, and tenant file audits to support regulatory compliance.
• Prepare scheduled and ad hoc reports and validate their accuracy.
• Provide administrative support to the supervisor and assigned team.
• Serve on internal committees as needed and provide backup coverage for certain positions during breaks, meal periods, vacations, and sick leave.
• Keep relevant data up to date in applicable systems and databases, including HMIS, Yardi, Intacct, Office Ally, and Rippling.
• Maintain electronic files in accordance with applicable guidelines and complete data entry in a timely manner.
• Participate in service trainings for client-facing staff when assigned.
• Screen prospective participants for service eligibility, as applicable to the team.
• Liaise with internal and external service resources, including referring agencies, vendors, and service partners.
• Coordinate outside vendors, purchases, and deliveries when asked.
• Perform other administrative, data, or program duties as assigned.

Benefits

• 18 days of paid time off.
• 15 paid holidays, including the employee's birthday.
• 100% employer-paid medical insurance for employees, with Kaiser, Sutter Health, and Anthem Blue Cross options; 50% coverage for dependents.
• 100% employer-paid group term life insurance, accidental death and dismemberment insurance, and long-term disability insurance.
• Up to $3,000 per year in tuition reimbursement.
• 403(b) plan with employer matching contribution.
• Pet insurance.
• Employee Assistance Program.
• Discount Marketplace.
• Internal growth opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed