Medical Billing Specialist I/II

THE POSITION

Candidates should take the time to read all the elements of this job advert carefully Please make your application promptly.

Under general supervision (I), direction (II), the incumbent performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements.

DISTINGUISHING CLASSIFICATION LEVELS

Positions are allocated to the various levels in this series on the basis of level, scope and complexity of professional billing duties assigned.

Medical Billing Specialist I ($19.98 - $25.34 per hour) : is the entry level in this series. Incumbents work under supervision of higher level Medical Billing Specialists and within established guidelines.

Medical Billing Specialist II ($22.90 - $29.05 per hour) : is the journey level class performing a variety of billing and processing claims for reimbursement by programs.

AGENCY / DEPARTMENT : Health Care Agency

VETERAN’S POINTS : This is a trainee / entry level classification (Level I / II), and Veteran’s Points may apply to eligible candidates.

Medical Billing Specialist I / II are represented by the Service Employees' International Union (SEIU) and are eligible for overtime compensation.

The eligible list established from this recruitment may be used to fill current and future Regular (including Temporary and Fixed-Term), Intermittent, and Extra-Help vacancies.

There is currently one (1) Regular vacancy in Patient Financial Services.

NOTE : If appointed at the lower level, incumbent may be promoted to the higher level without further exam upon meeting the minimum requirements, demonstrating satisfactory performance, and in accordance with the business needs of the department.

TENTATIVE SCHEDULE

OPENING DATE : 9 / 19 / 24

CLOSING DATE : 10 / 4 / 24

Medical Billing Specialist I and II :

• 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.

EDUCATION, TRAINING, AND EXPERIENCE

Any combination of education and experience which has led to the acquisition of the required knowledge, skills, and abilities.

The required knowledge, skills, and abilities can typically be obtained by 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.

Desired :

• 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.

KNOWLEDGE, SKILLS AND ABILITIES

Working to thorough knowledge of (depending on level in the series) :

• 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.
• Process bills accurately and receive prompt reimbursements.
• Research accounts for overcharges, appropriate billing information, and appropriate payment methodology.
• Evaluate and identify compliance and audit issues and work progressively with the compliance office to identify and resolve regulatory conflicts.

FINAL FILING DATE : Your application must be received by County of Ventura Human Resources in Ventura, California, no later than 5 : 00 p.

m. on Friday October 4th, 2024.

To apply online, please refer to our website at www.ventura.org / jobs. If you prefer to fill out a paper application form, please call (805) 654-5129 for application materials and submit them to County of Ventura Human Resources, 800 South Victoria Avenue, L-1970, Ventura, CA 93009.

Note to Applicants : It is essential that you complete all sections of your application and supplemental questionnaire thoroughly and accurately to demonstrate your qualifications.

A resume may be attached to supplement your responses in the above referenced sections; however, it may not be substituted in lieu of the application.

LATERAL TRANSFER OPTION : If presently permanently employed in another "merit" or "civil service" public agency / entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a "merit" or "civil service" style examination, then appointment by "Lateral Transfer" may be possible.

If interested, please click here for additional information.

SUPPLEMENTAL QUESTIONNAIRE qualifying : All applicants are required to complete and submit the questionnaire for this examination at the time filing.

The supplemental questionnaire may be used throughout the examination process to assist in determining each applicant's qualifications and acceptability for the position.

Failure to complete and submit the questionnaire will result in the application being removed from consideration.

APPLICATION EVALUATION qualifying : All applications will be reviewed to determine whether the stated requirements are met.

Those individuals meeting the stated requirements will be invited to continue to the next step in the screening and selection process.

WRITTEN EXAM 100% : A job-related written examination will be administrated to test applicants’ knowledge of Office Practices / Language Skills, Math / Chart Skills, and Medical Billing.

Applicants must earn a score of seventy percent (70%) or higher to qualify for placement on the eligible list. Applicants successfully completing the examination process may be placed on an eligible list for a period of one (1) year.

BACKGROUND INVESTIGATION : A thorough pre-employment, post-offer background investigation which may include inquiry into past employment, education, criminal background information, and driving record may be required for this position.

EQUAL EMPLOYMENT OPPORTUNITY

The County of Ventura is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.

For further information about this recruitment, please contact Brett Ramirez by e-mail at [email protected] or by telephone at (805) 654-2277.

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