Medical Billing Specialist II - Patient Financial Services

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　　Medical Billing Specialist II - Patient Financial Services

　　Salary

　　$47,635.01 - $60,431.44 Annually

　　Location

　　throughout Ventura County, CA

　　Job Type

　　Fixed Term

　　Job Number

　　0839HCA-24AA (EN)

　　Department

　　Health Care Agency

　　Opening Date

　　01/05/2024

　　Description

　　Benefits

　　Questions

　　Description

　　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 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.)

　　Examples Of Duties

　　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.

　　Typical Qualifications

　　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

　　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:

　　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.

　　Recruitment Process

　　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 (http://vcportal.ventura.org/CEO/HR/docs/Lateral_Transfer.pdf) 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 [email protected] 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.

　　Service Employees International Union (LOCAL 721)

　　(SEIU)

　　To learn more about Benefits, Retirement, and the Memorandum of Agreement (MOA), see links below.

　　Benefits website (https://hr.ventura.org/benefits) or you may call (805) 654-2570.

　　Retirement FAQ's (https://vcportal.ventura.org/CEO/benefits/docs/RETIREMENT%20-%20FAQs.pdf)

　　Memorandum of Agreement

　　Union Code: UPP

　　01

　　The exam for this recruitment consists of a Training and Experience (T&E) Evaluation, where your answers to the following questions will be evaluated to assess your qualifications along with your application. If you do not answer the following questions fully and completely, you may be disqualified from moving forward in the process. Do you understand this statement?

　　Yes, I understand the above.

　　02

　　Describe your full-time experience in professional medical billing, including billing in Medi-Cal, Commercial Insurance, Medicare and/or chemotherapy and using medical reimbursement systems.

　　Please include the following in your response:

　　Name of employer/Institution

　　Dates of employment reflected as MM/YYYY to MM/YYYY or Present

　　Number of hours worked per week

　　Detail examples of duties you performed

　　If you do not have this type experience, please state, "No experience.",

　　NOTE: Full time is considered 40 hours per week; anything less than that must be prorated.

　　IMPORTANT: You must include the employer(s) where you gained this experience in the Work Experience section of your application, as well as the details outlined in that section, in order to receive credit for that experience.

　　03

　　Describe your knowledge and professional experience using Current procedural terminology codes (CPT), International Classification for Diseases (ICD-10) codes, and Health Care Procedure Coding Systems (HCPCS) codes. If you do not have this experience, please write "no experience".

　　04

　　Describe a time in your professional experience where you were tasked with identifying a compliance and/or audit issue. In your answer, please provide an overview of the project and how you completed it successfully.

　　05

　　Provide a detailed example of a time when you used effective communication to maintain positive relationships with customers and colleagues.

　　Required Question

　　Agency

　　Ventura County

　　Address

　　800 S. Victoria Avenue LOC. #1970 Ventura, California, 93009

　　Phone

　　(805) 654-5129

　　Website

　　http://hr.ventura.org

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