Medical Billing Specialist I/II - Behavioral Health

Ventura County • Oxnard, CA

2d

About The Position

As a vital department of Ventura County Health Care Agency (HCA), Ventura County Behavioral Health (VCBH) provides comprehensive mental health and substance use treatment services tailored to meet the needs of our community. From mobile crisis response to outpatient treatment, our array of programs ensures individuals receive the support they need at every stage of their journey. Under general supervision at the (I) level, or direction at the (II) level, the incumbent is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements.

Requirements

• Any combination of education and experience which has led to the acquisition of the required knowledge, skills, and abilities.
• Hands-on working knowledge and experience in a medical complex comparable to Ventura County Medical Center and affiliated clinics.
• Medical Billing Specialist I - Minimum of six (6) months of medical billing experience required.
• Medical Billing Specialist II - Two (2) years of professional medical billing experience including billing in Medi-Cal and/or chemotherapy OR one (1) year as a Medical Billing Specialist I for the County of Ventura.
• Working (Level I) to thorough (Level II) knowledge of: Medical reimbursement programs and complexity of payment systems.
• Current Procedural Terminology Codes (CPT) codes, International Classification for Diseases (ICD)-10 codes, Health Care Procedure Coding System (HCPCS) codes for payment processing of Medicare and/or Medi-Cal.
• Medi-Cal Provider Manual for Billing and Policy and Program and Eligibility.
• Treatment Authorization Request (TAR) process.
• Ability to demonstrate open and direct communication with peers, managers, patients, and payers.
• Ability to process bills accurately and receive prompt reimbursements.
• Ability to research accounts for overcharges, appropriate billing information, and appropriate payment methodology.
• Ability to evaluate and identify compliance and audit issues and work progressively with the compliance office to identify and resolve regulatory conflicts.

Nice To Haves

• Associate's or Bachelor's degree in a business-related field.
• Experience in Managed Care/Medicaid/Medi-Cal/Medicare and/or Commercial Insurance billing.
• Experience with multiple electronic health record (EHR) systems, such as Cerner, HURON, and/or Claim Source to follow up on accounts.

Responsibilities

• Reviews and analyzes bills as they come off the system and bills/ transmits them in a timely manner to the appropriate intermediary
• Ensures accuracy and compliance with billing, coding, and follow-up requirements and identifies overpayments and lack of documentation issues
• Maintains work queue with backlog to 46 hours of receipt only
• Reviews and follows up on denial codes transmitted to providers for potential reimbursement on claims
• Provides information to payors and ensures that reimbursement is received
• Gathers, compiles, and analyzes billing and statistical analysis
• Prepares bills and claims and transmits them on a timely basis
• Performs other related duties as required

Benefits

• Educational Incentive - An educational incentive of 2.5% for completion of an associate degree, 3.5% for completion of a bachelor's degree, or 5% for completion of a graduate degree.
• Bilingual Incentive - Incumbents may be eligible for bilingual incentive depending upon operational need and certification of skill. Proficiency levels by exam are $0.69/hour (Level I), $1.00/hour (Level II), or $1.32/hour (Level III).
• Merit Increases - New employees serving their initial County service probationary period are eligible for an initial 5% merit increase upon completion of at least 1,040 hours (approximately six months) assuming work meets satisfactory standards. Subsequent merit increases will be upon completion of each additional 2,080 hours (approximately one year) from the initial merit increase.
• Deferred Compensation - Eligible to participate in the County's 401(k) Shared Savings Plan and/or the Section 457 Plan. If you participate in the County sponsored 401(k) plan, the County will match a part of your contribution up to 3% of your salary, on a per pay period basis. Following five (5) years of continuous County service, an additional 2% non-elective contribution will be made to the 401(k) plan.
• Health Plans - You are afforded a flexible credit allowance for purchasing medical plan under the County’s Flexible Benefits Program. County now pays 100% of dental, and vision premiums.
• Flexible Spending Accounts - Pre-tax benefit towards eligible medical, dental, and vision care expenses.
• Pension Plan - Participate in the County's defined benefit pension plan that provides lifetime payments to retirees. Members are "vested" after attaining five years of retirement service credit. If eligible, you may establish reciprocity with other public retirement systems such as CalPERS.
• Holidays - 13 paid days per year which includes a scheduled floating holiday.
• Tuition Reimbursement
• Disability Plans
• Employee Assistance Program
• Life Insurance
• Wellness Program

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree