Intake and Billing Specialist

Intake and Billing Specialist

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-Cal's 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 :

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