Billing Specialist

<p><span style="color: #000000;">The<strong> Billing Specialist</strong> is responsible for ensuring the accurate and efficient processing of billing and reimbursement for services provided in assigned programs and regions. This role involves preparing, submitting, and tracking insurance claims, as well as reconciling payments to ensure timely and accurate reimbursement from payers. The Billing Specialist also serves as a key point of contact for addressing billing-related inquiries, fostering transparency, and understanding in the billing process. </span></p> <p><span style="color: #000000;">Billing Specialist will be supporting multiple programs: Unconditional Education (UE) Outpatient (OP), UE Mosaic, UE Constellation, UE Ala Pathways Medical. </span></p> <p><span style="color: #000000;"><strong>ABOUT THE UE ROOTED TO RISE PROGRAM</strong></span></p> <p><span style="color: #000000;">Seneca’s <strong>Unconditional Education Rooted to Rise Program</strong> partners with Oakland Unified School District to provide therapeutic and behavioral intervention services for children and families in critical need of support, resources and care. Our Medi-Cal funded program provides individual, family and group therapy as well as push-in behavioral intervention and social skills development during the school day to students. Our team integrates into the school community, collaborates with school partners to deliver interventions and services needed for students to thrive. Learn more about</span> <a href="https://senecafoa.org/unconditional-education-and-school-based-services/" target="_blank" rel="noopener">Seneca’s School Partnership Programs and Unconditional Education model</a>.</p> <p><span style="color: #000000;"><strong>About Seneca</strong></span></p> <p><span style="color: #000000;"><strong>Seneca Family of Agencies </strong>has been nominated among the</span> <a href="https://topworkplaces.com/company/seneca-family-of-agencie/bayarea/" target="_blank" rel="noopener">Bay Area’s Top Workplaces</a> <span style="color: #000000;">for nearly a decade. We’re committed to providing traditionally marginalized communities with a network of outstanding mental health, community-based, and educational services. We are committed to building a diverse staff, and our programs actively engage in conversations and training on</span> <a href="https://senecadei.wordpress.com/" target="_blank" rel="noopener">Diversity, Equity, and Inclusion</a> <span style="color: #000000;">to promote equity and justice for the youth and families we serve.</span></p> <p><span style="color: #000000;"><strong>Responsibilities:</strong></span></p> <ul> <li><span style="color: #000000;">Prepare and submit accurate claims, invoices and required documentation for services, including coding diagnoses and procedure codes. </span></li> </ul> <ul> <li><span style="color: #000000;">Monitor and track claims to ensure timely submission and investigate and resolve billing inaccuracies and billing related issues.</span></li> </ul> <ul> <li><span style="color: #000000;">Check eligibility and benefit verification to determine client’s eligibility and if additional private health insurance exists for each client. </span></li> </ul> <ul> <li><span style="color: #000000;">Collaborate with funders and insurance companies to resolve billing inconsistencies and errors. </span></li> </ul> <ul> <li><span style="color: #000000;">Communicate with program and QA staff regarding any changes to a client’s eligibility. </span></li> </ul> <ul> <li><span style="color: #000000;">Bill and collect copays/deductibles from parents/guardians in applicable programs.</span></li> </ul> <ul> <li><span style="color: #000000;">Upload files to respective systems to apply payments and adjustments and provide reports from the electronic health record system. </span></li> </ul> <ul> <li><span style="color: #000000;">Review billing denial queues and billing-related reports on a daily basis to ensure the timely processing of claims and denials. Resubmit claims as needed. </span></li> </ul> <ul> <li><span style="color: #000000;">Communicate with program staff regarding corrections or necessary changes in documentation. </span></li> </ul> <ul> <li><span style="color: #000000;">Input, complete, and review billing and payment invoices using internal and external Electronic Health Record (EHR) and Clearinghouse systems for assigned program(s) and submit reports in a timely manner. </span></li> </ul> <ul> <li><span style="color: #000000;">Maintain proper documentation for each claim, including relating to the approval or denial of claims, utilizing the appropriate county forms and systems.</span></li> </ul> <ul> <li><span style="color: #000000;">Reconcile payments and resolve discrepancies. Work with payers to appeal and correct errors.</span></li> </ul> <ul> <li><span style="color: #000000;">Stay up to date on changes in billing codes, regulations, and payer policies.</span></li> </ul> <ul> <li><span style="color: #000000;">Attend all required trainings and meetings. </span></li> </ul> <ul></ul> <ul></ul> <p><span style="color: #000000;"><strong>Qualifications:</strong></span></p> <ul> <li><span style="color: #000000;">Education/experience requirement:</span> <ul> <li><span style="color: #000000;">Bachelor’s degree OR</span></li> <li><span style="color: #000000;">Associate degree + 1 year of applicable work experience OR</span></li> <li><span style="color: #000000;">High school diploma/GED + 2 years of applicable work experience.</span></li> <li><span style="color: #000000;">Applicable work experience includes relevant experience in data entry, claims processing, and revenue cycle billing. </span></li> </ul> </li> <li><span style="color: #000000;">Familiar with most Medical Insurance Payors including Medi-Cal and commercial insurance preferred. </span></li> <li><span style="color: #000000;">Strong computer skills with a high level of proficiency in Excel. </span></li> <li><span style="color: #000000;">Demonstrated organizational, analytical and problem-solving skills with the ability to move issues forward to resolution. </span></li> <li><span style="color: #000000;">Extremely detail oriented with strong skills in organizing, tracking, and maintaining large amounts of information. </span></li> <li><span style="color: #000000;">At least 21 years of age.</span></li> <li><span style="color: #000000;">TB test clearance, fingerprinting clearance, and any other state/federal licensing or certification requirements.</span></li> </ul> <p><span style="color: #000000;"><strong>Schedule</strong></span></p> <ul> <li><span style="color: #000000;">Full-time, Remote</span> <ul> <li><span style="color: #000000;">Monday - Friday, 9am - 5:30pm</span></li> </ul> </li> </ul> <p><span style="color: #000000;"><strong>Benefits</strong></span></p> <ul> <li style="vertical-align: middle; color: black;"><span>Starting at $28.41 - $30.91 per hour</span></li> <ul> <li style="vertical-align: middle; color: black;"><span>Actual salary is dependent on creditable experience above the minimum qualifications for the role</span></li> <li style="vertical-align: middle; color: black;"><span>Salary increases each year</span></li> </ul> <li style="vertical-align: middle; color: black;"><span>5 weeks of Paid Time off and 11 Paid Holidays</span></li> <li style="vertical-align: middle; color: black;"><span>Comprehensive benefits package: </span></li> <ul> <li style="vertical-align: middle; color: black;"><span>Medical, dental, vision, chiropractic, acupuncture, and fertility coverage</span></li> <li style="vertical-align: middle; color: black;"><span>50% paid premiums for dependents</span></li> <li style="vertical-align: middle; color: black;"><span>Long-term disability, family leave, and life insurance</span></li> <li style="vertical-align: middle; color: black;"><span>403b Retirement Plan</span></li> <li style="vertical-align: middle; color: black;"><span>Employer-paid Employee Assistance Plan</span></li> </ul> <li style="vertical-align: middle; color: black;"><span>Scholarship opportunities, ongoing training, and professional development opportunities</span></li> <li style="vertical-align: middle; color: black;"><span style="color: black;">Seneca is a </span><a href="https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service" target="_blank" rel="noopener"><span>Public Service Loan Forgiveness</span></a><span style="color: black;"> certified employer</span></li> <li style="vertical-align: middle; color: black;"><span>Promotional opportunities across the agency in California and Washington</span></li> </ul>

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

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When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

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Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

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Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

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Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

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This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...