Intake and Billing Specialist

Description

OVERVIEW :

The Intake and Billing Specialist, will be responsible for ensuring pre-authorization for client intake and for submitting billing to Managed Care Plan Providers for services provided under the CalAim Short Term Post-Hospitalization Housing Program.

DUTIES AND RESPONSIBILITIES :

• Establish and obtain pre-authorization for client eligibility prior to intake into the program using the Medi-Cals TAR (Treatment Authorization Form) and maintain authorizations for each patient
• Accounts Receivable billing and collection from Managed Care Plan Providers
• Complete the intake of clients into the program including required documentation as directed
• Medi Cal coding for all reimbursable medical services received following program procedures
• Input of medical billing codes for claims into medical billing software in a timely manner meeting submission timelines
• Assist with resolving questions and / or problems with billing
• Follow-up with billings and claims
• Reconciliation and auditing of accounts receivable
• Reviews and verifies accuracy, completeness, and integrity of claims
• Maintains files for the Post-Hospitalization Program
• Other related duties as required

EDUCATION AND EXPERIENCE :

SKILLS AND ABILITIES :

PHYSICAL REQUIREMENTS :

EQUIPMENT USED :

Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.

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