Hillsides
Billing Specialist II (Commercial Insurance)
Hillsides, Pasadena, California, United States, 91122
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 SchedulingSalary Range:
$23 - $27 per hour, DOEWhat We Offer:An outstanding benefits package and numerous opportunities for career growth and advancement within our organization.Bilingual stipend of $2,000 for applicable positions13 Paid Holidays per year including Cesar Chavez & Juneteenth, earn up to 22 days of PTOOpportunity to gain extensive work experience as a clinician working with children & familiesRobust 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.Medical insurance offering 3 HMO with Kaiser and Health Net, and also a PPO PlanDental insurance both HMO & PPO options, with 100% employer paid for HMO employee only coverage planLife and AD&D insurance 100% employer paid up to two times the annual salaryLong Term DisabilityFlexible Spending Account for Medical and Dependent Care401(k) with no wait period and no vesting schedule401(k) matchingEmployee Assistance ProgramThe essential functions include:Effectively manage billing processes for multiple insurance payors, ensuring accuracy and compliance with respective guidelinesSubmit claims to insurance carriers in a timely manner, meticulously adhering to submission requirementsPost payments accurately to maintain up-to-date financial recordsConduct a high volume of claim follow-up calls to insurance carriers, diligently researching and resolving account issues dailyDemonstrate expertise in interpreting Explanation of Benefits (EOB) from insurance carriers, ensuring a comprehensive understanding for informed decision makingApply knowledge in Verification of Benefits, prior authorizations, concurrent reviews, and adeptly address and resolve insurance-related issuesPossess an understanding of insurance cards, medical terminology, medical benefits, and proficiency in CPT/HCPCS and ICD-10 codingFollow up with insurance companies to confirm the receipt of documentation, and ensure the initiation and progress of prior authorizations and/or gap exceptions from contracted health plansConsult with clinical program to ensure that documentation for is complete for any insurance payment purposes, fostering collaboration between billing and clinical teamsSupport patients throughout the billing processFielding patient complaints and questionsUtilize tools and resources to provide accurate estimated reimbursements, offering well-informed policy recommendations to optimize revenue streamsAppropriately document all correspondence with clients and third-party insurances, maintaining thorough and organized records to support accountability and transparencyOther duties as requiredEDUCATION, EXPERIENCE & CERTIFICATESMinimum 2 years' experience in Medical BillingMinimum 1 year experience in Verification of BenefitsHigh School Diploma or equivalent requiredTRAUMA 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.
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Full-time Opportunity with Flexible SchedulingSalary Range:
$23 - $27 per hour, DOEWhat We Offer:An outstanding benefits package and numerous opportunities for career growth and advancement within our organization.Bilingual stipend of $2,000 for applicable positions13 Paid Holidays per year including Cesar Chavez & Juneteenth, earn up to 22 days of PTOOpportunity to gain extensive work experience as a clinician working with children & familiesRobust 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.Medical insurance offering 3 HMO with Kaiser and Health Net, and also a PPO PlanDental insurance both HMO & PPO options, with 100% employer paid for HMO employee only coverage planLife and AD&D insurance 100% employer paid up to two times the annual salaryLong Term DisabilityFlexible Spending Account for Medical and Dependent Care401(k) with no wait period and no vesting schedule401(k) matchingEmployee Assistance ProgramThe essential functions include:Effectively manage billing processes for multiple insurance payors, ensuring accuracy and compliance with respective guidelinesSubmit claims to insurance carriers in a timely manner, meticulously adhering to submission requirementsPost payments accurately to maintain up-to-date financial recordsConduct a high volume of claim follow-up calls to insurance carriers, diligently researching and resolving account issues dailyDemonstrate expertise in interpreting Explanation of Benefits (EOB) from insurance carriers, ensuring a comprehensive understanding for informed decision makingApply knowledge in Verification of Benefits, prior authorizations, concurrent reviews, and adeptly address and resolve insurance-related issuesPossess an understanding of insurance cards, medical terminology, medical benefits, and proficiency in CPT/HCPCS and ICD-10 codingFollow up with insurance companies to confirm the receipt of documentation, and ensure the initiation and progress of prior authorizations and/or gap exceptions from contracted health plansConsult with clinical program to ensure that documentation for is complete for any insurance payment purposes, fostering collaboration between billing and clinical teamsSupport patients throughout the billing processFielding patient complaints and questionsUtilize tools and resources to provide accurate estimated reimbursements, offering well-informed policy recommendations to optimize revenue streamsAppropriately document all correspondence with clients and third-party insurances, maintaining thorough and organized records to support accountability and transparencyOther duties as requiredEDUCATION, EXPERIENCE & CERTIFICATESMinimum 2 years' experience in Medical BillingMinimum 1 year experience in Verification of BenefitsHigh School Diploma or equivalent requiredTRAUMA 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.
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