This position is responsible for the timely submission of medical claims to insurance companies linked to Medi-Cal or Medicare in a timely manner and following up with claims resolution and revenue realization.
May perform any or all of the following depending upon department needs:
- Performs specialized medical billing claims resolution. Organizes, updates, and continuously proofs data entry making corrections as needed.
- Follow-up on unpaid claims within standard billing cycle timeframes; Post insurance company payments in electronic health records, and resolve denied claims.
- Generates reports for review as required or requested by Business Office Manager or others
- Interfaces with division and Agency personnel, and attends meetings as scheduled and or needed.
- Develops and maintains claim resolution skill through workshops or other forms of training/education.
- Performs a variety of general clerical duties; prepares a variety of routine correspondence, forms, reports and similar items using word processing, spreadsheet, and data entry software.
- Evaluates client and other files and submits reports as required by management,
- Copies, sorts, faxes, collates, binds and retrieves documents.
- Responds to incoming program telephone calls in a timely, friendly manner and assist callers as able, checks and responds to e-mails
- Maintains Agency-wide County and State access cards and license requirements for billable staff.
These specifications are general guidelines based upon the minimum, ordinarily considered essential, to satisfactory performance in this position. Individual skills and abilities may result in some deviation from these guidelines.
To perform effectively in this position, the employee in this position is required to have:
- A minimum of one yearexperience billing in a DMH mental health/substance use setting
- Ability to work denied claims
- A working knowledge of HMO, & Medi-Care
- A working knowledge of data entry and the skills to efficiently use the computer including Microsoft Word and Excel
- General clerical skills and experience including filing, reception, use of office machines, and contemporary office procedures.
- Basic math skills to calculate routine data
- Support the values and mission of Didi Hirsch as related to employment
- Know and comply with Agency policies and procedures
- Present ideas, information, and viewpoints clearly, both verbally and in writing
- Demonstrate commitment to team objectives and Didi Hirsch philosophies
- Adapt to changing needs by acquiring new skills and knowledge
- Current California driver’s license and a driving record acceptable to the Agency’s insurance carrier
- Experience in claiming of Substance Abuse Prevention and Control (SAPC) Drug Medi-Cal is preferred but not required.
These requirements are typically met by a combination of education and experience that typically includes a high school diploma and one year or more of clerical support and/or data entry experience.