Medical Billing Program Specialist II

·       Respond to calls and emails, providing high quality customer service by responding promptly, accurately, and professionally to all inquiries and requests for assistance.

·       Track and document billable services; prepare, submit, and monitor CalAIM/Medi-Cal billing claims; review claims for accuracy and completeness; research and resolve denied or rejected claims; maintain billing records and supporting documentation; and prepare billing-related reports to ensure compliance with agency, funding, and regulatory requirements.

·       Provide intake support by assisting with client screenings, intake paperwork, eligibility verification, appointment scheduling, and record maintenance.

·       Assist with preparation, distribution, and filing of correspondence, notices, invitations, reports, files, etc.

·       Assist with program/client/tenant file audits to ensure program regulatory compliance.

·       Prepare scheduled and ad-hoc reports and validate for accuracy.

·       Provide administrative support to supervisor and assigned team.

·       May serve on internal committees as needed.

·       Serves as backup for certain positions as needed for employee breaks, meal periods, vacation and sick leave coverage.

·       Other administrative duties as assigned.

·       Keep all relevant data up to date in applicable systems and databases (HMIS, Yardi, Intacct, Office Ally, Rippling, etc.)

·       Maintain electronic files in accordance with applicable guidelines, completing data entry timely.

·       Participate in service trainings for front (client) facing staff when assigned.

·       Perform other data or program duties as requested.

·       Screening prospective participants for eligibility of services.

·       Acting as a liaison to internal and external service resources, including communication and correspondence with referring agencies, vendors, and service partners.

·       Provide coordination of outside vendors, purchases, deliveries, etc…when asked.

·       Adaptability with an enthusiastic and positive attitude

·       Excellent, professional, communication skills, including maintaining confidentiality and setting boundaries. 

·       Ability to use basic office and computer equipment, including single and multi-line telephones, copiers, scanners, facsimile machines.

·       Ability to produce, distribute, organize, file, and store documents (paper and electronic).

·       Competency in data entry and ability to work with a web-based database.

·       Customer service and problem-solving approach and skills as demonstrated through patience, tolerance, tact, diplomacy, and flexibility in all situations.

·       Well organized and ability to effectively manage multiple assignments to meet project deadlines.

·       Demonstrates accuracy and thoroughness, monitors own work to ensure quality and applies feedback to improve performance.

·       Familiar with and able to use Office Ally or any other medical billing portal

·       Familiar with Partnership Health Plan, Kaiser Permanente, Sutter Health and North Bay Health providers

·       Have a clear understanding of Community Supports Services and Enhanced Care Management

·       Experience that demonstrates a capacity to provide support to managers and staff in various administrative duties as well as special projects.

·       Experience with CalAIM, Medi-Cal, or other healthcare billing processes, including claims submission, billing documentation, and use of billing portals, preferred.

·       Skilled in Microsoft Office Outlook, Word, Excel and Adobe programs.

·       Access to reliable personal transportation required, including a DMV record that permits driver to be insured under SHELTER, Inc.’s automobile coverage.

·       Must successfully pass a criminal background check.

·       Type at a minimum of 35 words per minute.

·       Associates degree in administrative services or related area, and/or certification from a two year program in related area.

·       Experience with Yardi, HMIS, Intacct, Rippling, and Office Ally.

·       Experience working with low income and/or homeless populations.

·       Experience working in diverse settings with people across all socio-economic spectrums and a wide variety of personalities and roles - staff, residents, local agencies, contractors, lenders, etc.

·       Bilingual English/Spanish

The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk and hear. The employee is often required to sit and use their hands and fingers to handle or feel objects. The employee is occasionally required to stand, walk, reach with hands and arms, climb or balance, and stoop, kneel, crouch or crawl. Specific vision abilities required by this job include close vision.

The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job.

There are no unusual environmental conditions. Typically, the noise level in the work environment is quiet.

SHELTER, Inc., is an equal opportunity employer. We believe diverse perspectives drive innovation and lead to better outcomes for the communities we serve. We strongly encourage applications from individuals with varied backgrounds, identities, and lived experiences.

Notice: This description is a guide only. Upon hire, you will receive a formal job description.