Billing Specialist Ii

We are a premier provider dedicated to healing children and young adults, strengthening families, and transforming communities through quality comprehensive services and advocacy. We envision a world in which children and young adults, families, and communities are able to heal, grow, and thrive.
Job Type: Full-time Opportunity with Flexible Scheduling
Salary Range: $23 - $27 per hour, DOE
Office Location: Pasadena, CA
What We Offer:
An outstanding benefits package and numerous opportunities for career growth and advancement within our organization.

• Bilingual stipend of $2,000 for application positions
• 13 Paid Holiday per year including Cesar Chavez & Juneteenth, earn up to 22 days of PTO
• Flexible work schedule
• Opportunity to gain extensive work experience as a clinician working with children & families
• Robust training opportunities: Evidence Based Practices, Shared Core Practice Model & Trauma Informed Care.
• Working with multi-disciplinary teams.
• This role is eligible for Public Service Loan Forgiveness (PSLF)
• Supervision available for Licensure.
• Working with multi-disciplinary teams.
• Medical insurance offering 3 HMO with Kaiser and Health Net, and also a PPO Plan
• Dental insurance both HMO & PPO options, with 100% employer paid for HMO employee only coverage plan
• Life and AD&D insurance 100% employer paid up to two times the annual salary
• Long Term Disability
• Flexible Spending Account for Medical and Dependent Care
• 401(k) with no wait period and no vesting schedule
• 401(k) matching
• Employee Assistance Program

The essential functions include:

• Demonstrate proficiency in verifying insurance benefits to ensure accurate and timely processing of claims
• Efficiently complete prior authorizations and conduct concurrent reviews, ensuring adherence to established protocols and guidelines
• Skillfully address and resolve insurance-related issues, demonstrating a comprehensive understanding of insurance cards, insurance benefits, medical terminology, CPT/HCPCS and ICD-10 coding
• Proactively liaise with insurance companies to track documentation, ensuring the initiation and progress of prior authorizations and/or gap exceptions from contracted health plans
• Actively participate in peer-to-peer reviews, collaborating with relevant stakeholders
• Consult with clinical program to guarantee the completeness of documentation for utilization reviews, maintaining a high standard of accuracy and compliance
• Support patients throughout the billing and onboarding process,
• Field patient complaints and questions
• Utilize tools and resources to accurately estimate reimbursements and offer well-informed policy recommendations
• Appropriately document all correspondence with clients and third-party insurances, ensuring a thorough and organized record-keeping process
• Other duties as required

EDUCATION, EXPERIENCE & CERTIFICATES

• Minimum 2 years' experience in Medical Billing
• Minimum 1 year experience in Verification of Benefits
• High School Diploma or equivalent required

TRAUMA INFORMED CARE (TIC)
Hillsides practices Trauma Informed Care (TIC) principles which recognizes the signs, symptoms, and widespread impact of trauma; Employees are asked to comprehensively integrate knowledge of Trauma Informed Care into policies, procedures, and practices with the goal to prevent re-traumatization which promotes healing of families, youth, individuals, and communities.
Seat 951

Job Type: Full-time

Pay: $23.00 - $27.00 per hour

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: Hybrid remote