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Redshieldmodesto

Intake and Billing Specialist

Redshieldmodesto, Modesto, California, United States, 95351

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Description OVERVIEW: The Intake and Billing Specialist, will be responsible for ensuring pre-authorization for client intake and for submitting billing to Managed Care Plan Providers for services provided under the CalAim Short Term Post-Hospitalization Housing Program.

DUTIES AND RESPONSIBILITIES:

Establish and obtain pre-authorization for client eligibility prior to intake into the program using the Medi-Cal’s TAR (Treatment Authorization Form) and maintain authorizations for each patient

Accounts Receivable billing and collection from Managed Care Plan Providers

Complete the intake of clients into the program including required documentation as directed

Medi Cal coding for all reimbursable medical services received following program procedures

Input of medical billing codes for claims into medical billing software in a timely manner meeting submission timelines

Assist with resolving questions and/or problems with billing

Follow-up with billings and claims

Reconciliation and auditing of accounts receivable

Reviews and verifies accuracy, completeness, and integrity of claims

Maintains files for the Post-Hospitalization Program

Other related duties as required

EDUCATION AND EXPERIENCE:

High school diploma or equivalent (required)

18 years old (required)

Education and /or experience in medical billing, especially Medi Cal billing and medical billing software

Medical terminology course passed with at least a “C” in the past 5 years (preferred)

Experience with disadvantaged populations, whether through work, volunteering is helpful

SKILLS AND ABILITIES:

Typing of 35 words per minute

10-key and data entry skills

Intermediate skills in Microsoft software to include Word, Excel, PowerPoint and Access

Ability to prioritize work and multi-task simultaneous tasks

Ability to communicate effectively and accurately

Have good social interaction skills

PHYSICAL REQUIREMENTS:

Ability to lift up to 25 lbs. (usually file boxes)

EQUIPMENT USED:

Modern Office Equipment and Relevant Software

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.

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