Medical Billing Specialist

Medical Billing Specialist

Reports to: Director of Housing Services

Classification: Full-Time

FLSA Status: Exempt

Compensation: $70,000 - $78,000. We would expect those hired into this job would be paid within this range.

UWCCR Company Information

At United Way California Capital Region (UWCCR), we believe creating stronger, healthier, more compassionate communities starts at Square One: Helping every family succeed so their community can too. Families know what they need to thrive. We are their partners on that path, connecting them with resources to achieve their goals. United Way California Capital Region is now working on an even larger scale to help families heal and meet our 20-year promise to significantly reduce poverty in the Capital Region. We are laying solid steppingstones on our path to help every family thrive and build a healthy community.

Anti-racism, Diversity, and Inclusion.

UWCCR recognizes and affirms that all people are created equal and are entitled to all rights afforded by the Constitution of the United States. Our Human Resources and Executive Team are committed to promoting Anti-Racism, Diversity, and Inclusion efforts to address racial inequities and disparities. We live these values by improving equity, diversity, and inclusion in recruitment, selection, and employment practices. We aspire to recruit, employ, retain, and promote talented individuals representing the full spectrum of our community, and welcome all candidates, including candidates of any race, religion, national origin, gender identity or expression, sexual orientation, and age, and candidates with disabilities.

Position Description:

Reporting to the Director of Housing Services, the Medical Billing Specialist is responsible for acting as a liaison between the Housing Services and Finance teams in managing timely and accurate submissions of insurance claims. They facilitate effective follow-up and receipting of insurance claims to ensure that program delivery is efficient and effective. The Medical Billing Specialist works closely with the Housing Services Coordinator, Health Plan Partners, and various external staff to assist in housing individuals experiencing homelessness in the Sacramento region.

Classification Specification:

Under general supervision, Specialists contribute to the stated goals of UWCCR by providing functional and/or operational services within the affiliated department or program. They provide specialized support by utilizing general knowledge, skills, and abilities of the department’s particular field to complete various assignments of moderate difficulty. Coordinators may have contact with external partners to provide and gather information. They perform tasks with moderate complexity under the direction of departmental leadership.

Responsibilities:

Medical Billing – 75%

Responsible for the timely filing of technical and medical claims with insurance companies by using billing software. • Check invoices for correctness and completeness and work with various staff and partners to obtain missing information. • Follow up on unpaid invoices/claims. • Research and appeal of rejected invoice claims. • Reconcile housing support billings with accounting records and actively follow up on outstanding billing items. • Work claims and claim denial to ensure maximum reimbursement for services rendered. • Assist in Medi-Cal and insurance reviews and audits. • Generate billing reports and work closely with accounting for month end reporting. • Maintain contractual adjustment library in the billing software. • Work with finance in determining the gross billing rate for all billing codes. • Verifies insurance benefits and eligibility and obtains valid authorizations and referrals. • Links proper ICD-10 diagnosis code with appropriate CPT code for billing purposes. • Keep abreast of the changing billing regulations regarding CalAIM expansion. • Actively work to maintain lower bad debt percentage as prescribed by company policy. • Facilitate positive relationships and open communication between participants and their housing providers. • Meet weekly with the Housing Services team to obtain participant updates for reporting and to provide support. • Ensure all participants are enrolled in various systems and databases and that information is updated regularly. • Assist in training new Housing Services staff to ensure program efficiency and delivery. • Encourage, support, and assist Housing staff with issues that arise regarding participants. • Performs other related duties as required to support the mission of the organization and the program.

Departmental Support – 20%

Attend staff meetings, monthly partner meetings as requested, and case conferencing. • Effectively manage and build working relationships with others, including external partners and various UWCCR staff of all levels. • Assist management in compiling data, completing reports, and gathering supporting documents needed for the program. • Ensure documentation from staff is completed for billing at the beginning of each month. • Work in collaboration with Director, biller, accounting staff and all coordinators to create policies and procedures. • Confirm that staff have been trained in tenant rights and responsibilities, fair housing and all mandated training provided by the agency.

Additional Duties – 5%

Assist with miscellaneous projects and requests on an as needed basis.

Preferred Education and Experience

Bachelor’s degree in a related field; or equivalent in experience.

1+ years of relevant professional experience and related functions

Required Knowledge and Skills

Ability to quickly evaluate and prioritize in a high-volume environment and juggle multiple priorities/projects. • Self-starter and someone who takes the initiative to make process improvements and to solve problems. • Self-motivated with ability to meet deadlines independently and as part of a team. • Detail oriented and superior time management skills. • High level of interpersonal skills to handle sensitive and confidential situations and documentation. • Exceptional ability to build strong relationships, collaborate, and elevate issues to the appropriate levels. • Proficient with Microsoft Suite (Outlook, Excel, Word, and PowerPoint). • Excellent verbal and written communication skills. • Excellent interpersonal, negotiation, and conflict resolution skills. • Excellent organizational skills and attention to detail. • Strong analytical and problem-solving skills. • Ability to act with integrity, professionalism, and confidentiality.

Physical Requirements

Communicate with staff, volunteers, donors, agencies, companies and other customers by telephone, email, and in face-to-face, one-to-one or group settings. • Use telephone, laptop, computer, monitor, mouse, keyboard, printer/copier, calculator, and standard office equipment. • Sit at a desk for extended periods of time. • Lift and move objects up to 10 pounds such as large binders, boxes, books, and small office equipment. • Have sufficient finger/hand coordination and dexterity to operate and adjust office equipment such as telephone, computer, printer/copier, etc.

Special Requirements

Possession of an appropriate California operator’s license issued by the State Department of Motor Vehicles, and adequate automobile insurance; possession and maintenance of a good driving record (as evidenced by freedom from multiple or serious traffic violation for at least a two-year duration) that does not contribute to an increase in UWCCR insurance rates.

Job Type: Full-time

Pay: $70,000.00 - $78,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Retirement plan

Schedule:

• Monday to Friday

Work setting:

• Hybrid work
• Office

Work Location: Hybrid remote in Sacramento, CA 95827