What are the responsibilities and job description for the Medical Billing Specialist II - Patient Financial Services position at Ventura County?
THE POSITION: Under general direction, the incumbent is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements. The ideal candidate possesses strong customer service skills and is committed to providing service excellence while interacting with the public.
EDUCATIONAL/BILINGUAL INCENTIVE: Some positions may be eligible for educational incentive. This incentive may be 2.5%, 3.5%, or 5% for incumbents in eligible positions based on completion of an Associate's, Bachelor's, or Master's degree that is not required for the classification. Incumbents may also be eligible for bilingual incentive depending upon operational need and certification of skill.
AGENCY/DEPARTMENT: Health Care Agency
Medical Billing Specialist II - Two (2) years of professional medical billing experience including billing in Medi-Cal and/or chemotherapy OR one (1) year as a Medical Billing Specialist I for the County of Ventura.
To apply online, please refer to our website at www.ventura.org/jobs. If you prefer to fill out a paper application form, please call (805) 654-5129 for application materials and submit them to County of Ventura Human Resources, 800 South Victoria Avenue, L-1970, Ventura, CA 93009.
Note to Applicants: It is essential that you complete all sections of your application and supplemental questionnaire thoroughly and accurately to demonstrate your qualifications. A resume may be attached to supplement your responses in the above referenced sections; however, it may not be substituted in lieu of the application.
LATERAL TRANSFER OPTION: If presently permanently employed in another "merit" or "civil service" public agency/entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a "merit" or "civil service" style examination, then appointment by "Lateral Transfer" may be possible. If interested, please click here for additional information.
TRAINING & EXPERIENCE EVALUATION (100%): A Training and Experience Evaluation (T&E) is a structured evaluation of the job application materials submitted by a candidate, including the written responses to the supplemental questionnaire. The T&E is NOT a determination of whether the candidate meets the stated requirements; rather, the T&E is one method for determining who are the better qualified among those who have shown that they meet the stated requirements. In a T&E, applications are either scored or rank ordered according to criteria that most closely meet the business needs of the department. Candidates are typically scored/ranked in relation to one another; consequently, when the pool of candidates is exceptionally strong, many qualified candidates may receive a score or rank which is moderate or even low resulting in them not being advanced in the process.
The eligible list established will be created from the scores resulting from a Training and Experience Evaluation (T&E). In a typical T&E, your training and experience are evaluated in relation to the background, experience and factors identified for successful job performance during a job analysis. For this reason, it is recommended that your application materials clearly show your relevant background and specialized knowledge, skills, and abilities. It is also highly recommended that the supplemental questions within the application are completed with care and diligence. Responses such as "See Resume" or "Refer to Resume" are not acceptable and may disqualify an applicant from further evaluation. Applicants must earn a score of seventy percent (70%) or higher to qualify for placement on the eligible list.
If there are three (3) or fewer qualified applicants, a T&E will not be conducted. Instead, a score of seventy percent (70%) will be assigned to each application, and each applicant will be placed on the eligible list.
BACKGROUND INVESTIGATION: A thorough pre-employment, post offer background investigation which may include inquiry into past employment, education, criminal background information, and driving record may be required for this position.
For further information about this recruitment, please contact Erin Niemi by e-mail at Erin.Niemi@ventura.org or by telephone at (805) 654-2568.
EQUAL EMPLOYMENT OPPORTUNITY
The County of Ventura is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.
EDUCATIONAL/BILINGUAL INCENTIVE: Some positions may be eligible for educational incentive. This incentive may be 2.5%, 3.5%, or 5% for incumbents in eligible positions based on completion of an Associate's, Bachelor's, or Master's degree that is not required for the classification. Incumbents may also be eligible for bilingual incentive depending upon operational need and certification of skill.
AGENCY/DEPARTMENT: Health Care Agency
Medical Billing Specialist II is represented by the Service Employees' International Union (SEIU) and are eligible for overtime compensation.
The eligible list established from this recruitment may be used to fill current and future Regular (including Temporary and Fixed-Term), Intermittent, and Extra-Help vacancies. There are currently one (1) Fixed-Term position open in Patient Financial Services. The term will last for six (6) months, and will end approximately on June 20, 2024.
TENTATIVE SCHEDULE
OPENING DATE: January 5, 2024
CLOSING DATE: Continuous
(Previously: January 19, 2024 at 5:00 p.m.)
Duties may include, but are not limited to, the following:- Reviews and analyzes bills as they come off the system and bills/ transmits them in a timely manner to the appropriate intermediary/payor;
- Ensures accuracy and compliance with billing, coding, and follow-up requirements and identifies overpayments and lack of documentation issues and analyzes credits and overadjustments;
- Addresses submitted claims in work queue within two (2) business days of receipt;
- Reviews and follows up on denial codes transmitted to billing department and makes appropriate corrections and retransmits claims;
- Provides requested information to payors and ensures that reimbursement is received;
- Gathers, compiles, and analyzes billing and statistical analysis;
- Responds within 2 business days to third party payors, clinics, coworkers, supervisors, managers, physicians and the public by email/phone/written communication;
- Performs other related duties as required.
These are entrance requirements to the examination process and assure neither continuance in the process nor placement on an eligible list.
EDUCATION, TRAINING, AND EXPERIENCE
EDUCATION, TRAINING, AND EXPERIENCE
Any combination of education and experience which has led to the acquisition of the required knowledge, skills, and abilities. The required knowledge, skills, and abilities can typically be obtained by hands-on working knowledge and experience in a medical complex comparable to Ventura County Medical Center and affiliated clinics.
Medical Billing Specialist II - Two (2) years of professional medical billing experience including billing in Medi-Cal and/or chemotherapy OR one (1) year as a Medical Billing Specialist I for the County of Ventura.
Desired:
KNOWLEDGE, SKILLS AND ABILITIES
- Associate's or Bachelor's degree in a business-related field.
- Experience in Managed Care/Medicaid/Medi-Cal/Medicare and/or Commercial Insurance billing.
- Experience with multiple electronic health record (EHR) systems, such as Cerner, HURON, and/or Claim Source to follow up on accounts.
KNOWLEDGE, SKILLS AND ABILITIES
Knowledge of:
- Medical reimbursement programs and complexity of payment systems.
- Current Procedural Terminology Codes (CPT) codes, International Classification for Diseases (ICD)-10 codes, Health Care Procedure Coding System (HCPCS) codes for payment processing of Medicare and/or Medi-Cal.
- Medi-Cal Provider Manual for Billing and Policy and Program and Eligibility.
- Treatment Authorization Request (TAR) process.
Ability to:
- Demonstrate open and direct communication with peers, managers, patients, and payers.
- Process bills accurately and receive prompt reimbursements.
- Research accounts for overcharges, appropriate billing information, and appropriate payment methodology.
- Evaluate and identify compliance and audit issues and work progressively with the compliance office to identify and resolve regulatory conflicts.
FINAL FILING DATE: This is a continuous recruitment and may close at any time; therefore, apply as soon as possible if you are interested in it. Your application must be received by County of Ventura Human Resources no later than 5:00 p.m. on the closing date.
(Previously: Your application must be received by County of Ventura Human Resources no later than 5:00 p.m. on January 19, 2024 at 5:00 p.m.)
To apply online, please refer to our website at www.ventura.org/jobs. If you prefer to fill out a paper application form, please call (805) 654-5129 for application materials and submit them to County of Ventura Human Resources, 800 South Victoria Avenue, L-1970, Ventura, CA 93009.
Note to Applicants: It is essential that you complete all sections of your application and supplemental questionnaire thoroughly and accurately to demonstrate your qualifications. A resume may be attached to supplement your responses in the above referenced sections; however, it may not be substituted in lieu of the application.
LATERAL TRANSFER OPTION: If presently permanently employed in another "merit" or "civil service" public agency/entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a "merit" or "civil service" style examination, then appointment by "Lateral Transfer" may be possible. If interested, please click here for additional information.
SUPPLEMENTAL QUESTIONNAIRE – qualifying: All applicants are required to complete and submit the questionnaire for this examination at the time of filing. The supplemental questionnaire may be used throughout the examination process to assist in determining each applicant's qualifications and acceptability for the position. Failure to complete and submit the questionnaire will result in the application being removed from consideration.
APPLICATION EVALUATION – qualifying: All applications will be reviewed to determine whether the stated requirements are met. Those individuals meeting the stated requirements will be invited to continue to the next step in the screening and selection process.
TRAINING & EXPERIENCE EVALUATION (100%): A Training and Experience Evaluation (T&E) is a structured evaluation of the job application materials submitted by a candidate, including the written responses to the supplemental questionnaire. The T&E is NOT a determination of whether the candidate meets the stated requirements; rather, the T&E is one method for determining who are the better qualified among those who have shown that they meet the stated requirements. In a T&E, applications are either scored or rank ordered according to criteria that most closely meet the business needs of the department. Candidates are typically scored/ranked in relation to one another; consequently, when the pool of candidates is exceptionally strong, many qualified candidates may receive a score or rank which is moderate or even low resulting in them not being advanced in the process.
The eligible list established will be created from the scores resulting from a Training and Experience Evaluation (T&E). In a typical T&E, your training and experience are evaluated in relation to the background, experience and factors identified for successful job performance during a job analysis. For this reason, it is recommended that your application materials clearly show your relevant background and specialized knowledge, skills, and abilities. It is also highly recommended that the supplemental questions within the application are completed with care and diligence. Responses such as "See Resume" or "Refer to Resume" are not acceptable and may disqualify an applicant from further evaluation. Applicants must earn a score of seventy percent (70%) or higher to qualify for placement on the eligible list.
If there are three (3) or fewer qualified applicants, a T&E will not be conducted. Instead, a score of seventy percent (70%) will be assigned to each application, and each applicant will be placed on the eligible list.
BACKGROUND INVESTIGATION: A thorough pre-employment, post offer background investigation which may include inquiry into past employment, education, criminal background information, and driving record may be required for this position.
For further information about this recruitment, please contact Erin Niemi by e-mail at Erin.Niemi@ventura.org or by telephone at (805) 654-2568.
EQUAL EMPLOYMENT OPPORTUNITY
The County of Ventura is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.
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