Billing Analyst

Description

SUMMARY:

The Insurance Billing Analyst is a customer service position. The Insurance Billing Analyst’s work will consist of support in a team environment to the client which includes program staff, administrative staff, insurance companies and clients. The Insurance Billing Analyst must possess the ability to communicate effectively with clients, staff, payers, community partners, and all stakeholders both by phone and in person. This position is responsible for payment and service reconciliation. The Insurance Billing Analyst is also responsible for billing private insurance and following through on the payment of claims. The Insurance Billing Analyst must be able to multi-task and simultaneously identify priorities. Must be able to self-motivate and work independently in partnership with program staff, Billing Manager and Executives, Program Directors, and QA staff. The Insurance Billing Analyst must be able to work in a busy office environment and process county reports. The Insurance Billing Analyst must comply with all guidelines for various contracts, county and state guidelines and legal/ethical standards. Responsible for ensuring site appearance is suitable for excellent customer service.

JOB DUTIES & RESPONSIBILITIES:

1. Post paid MediCal and private insurance payments to client’s accounts.
2. SIMON CDCI Deletion.
3. Track unpaid services.
4. Credential SCCS and providers with various insurance companies
5. Print and Save SIMON Reports for all programs.
6. Provide community members with resources and assistance.
7. Research unpaid service claims.
8. Ensure services drop to MediCal.
9. Pull and Distribute Progress Note Transfer Error Reports.
10. Pull and Correct Batch Posting Error Report.
11. Print and Save SIMON Reports for all Programs.
12. Aid in Insurance Billing.
13. Aid in MediCare Billing.
14. Coordinate with staff for completion of Financial Chart Audits .
15. Participate in meetings as directed.
16. Respect clients’ and employees’ confidentiality at all times.
17. Demonstrate a working knowledge of all SCCS programs and contracts.
18. Demonstrate and model excellent working relationships with all SCCS staff members and stakeholders.
19. Performs other related duties as required and assigned.

Qualifications

GENERAL REQUIREMENTS:

        Education/Experience

1. One (1) year of office reception and administration experience.
2. High School Diploma or equivalent.
3. Experience with provider enrollment planning and implementation.
4. 3 years minimum experience in credentialing.
5. Strong knowledge of the healthcare insurance field.

Licensure, Registration, Certification

1. Valid CA driver’s license and proof of automobile insurance.
2. Completion of CPR/First Aid certification within the first thirty (30) days of employment.
3. AAPC certification preferred.