Job Summary:

We are seeking a detail-oriented Billing Specialist to manage the billing process for our services, ensuring accurate and timely billing, revenue collection, and proper documentation. The Billing Specialist will maintain strong working relationships with clients, staff, and external billing contractors, providing excellent customer service and addressing client billing needs, claim denials, appeals, and collections of outstanding and delinquent accounts.

Key Responsibilities:

• Accurately enter billing data into the County of Riverside Medi-Cal billing system, complete reconciliation reporting, and process invoices for monthly submission.
• Submit third-party insurance billing data to external billing contractors, ensuring timely follow-up on claims and addressing denials.
• Maintain collaborative relationships with external billing contractors and staff to ensure efficient billing and collections.
• Ensure that all necessary documentation supports the billing process.
• Verify Medi-Cal eligibility for clients on a monthly basis and monitor annual updates.
• Identify, address, and resolve billing discrepancies and outstanding invoices.
• Maintain CDCR data, working with the Program Manager and CDCR Contractor to complete monthly reports and service data.
• Allocate monthly service billings for contractors and applicable vendors.
• Maintain client data using the Concurrent Review system in the EHR system.
• Ensure accuracy of discharge dates on Bed Boards and billing data sheets.
• Provide backup support for accounts receivable and other accounting areas as needed.
• Assist with "ad hoc" reporting as required.
• Ensure compliance with company policies and procedures and HIPAA regulations.

Skills & Qualifications:

• Excellent communication skills: verbal, written, and listening comprehension.
• Strong collaboration skills: ability to work effectively with others, resolve conflicts, and provide excellent customer service.
• Dependable, organized, and able to prioritize work efficiently to meet deadlines.
• Demonstrates accuracy, commitment to quality, and a willingness to improve processes.
• Proficient with technology: experienced with electronic medical record programs, Microsoft Office (especially Excel), and adaptable to new technologies.
• Ability to work both independently and as part of a team under pressure.
• Maintains professionalism, confidentiality, and ethical behavior.

Required Experience:

• 3+ years of experience in healthcare or behavioral healthcare, preferably in a substance abuse facility.
• 2+ years of experience in medical billing systems (Drug Medi-Cal and ICD Billing knowledge preferred).
• Knowledge of medical terminology, office policies, and procedures.