Hourly Rate: TBD upon Education/ Experience 22+-25 Under the supervision of the Data & revenue Manager & QA/Medical Biller Coordinator, the Quality Assurance/Medical Biller is responsible for monitoring program compliance by conducting quality assurance reviews of client and provider files and providing feedback to supervisor and Clinical Director when non-compliance has been detected. Essential Functions • Process new clients in DMH system and EXYM (electronic management records • EMR- system) systems. • Work closely with the clinicians and case managers to ensure that required paperwork is received and processed in a timely manner. • Process claims through EDI billing and batch claims on a weekly basis to meet billing deadline. • Assist with auditing and researching data on EMR for quality assurance and DMH compliance. • Update CIN number and Card Issue Date changes in the DMH billing and EXYM systems. • Check Medi-Cal eligibility on active clients on a monthly basis by running the MOPIs (financial reports) by the 1st of every month. • Assist with running Medi-cal eligibility checks for all incoming referrals within a 24-hour turnaround. • Update all annual paperwork and client information in EXYM and charts. • Process all discharges and audit client chart and billing. • Attend all necessary DMH and Revenue trainings/meetings to keep up with any changes and updates regarding billing issues and claims submission. • Audit assigned program to ensure accuracy, assist team with MIS tasks when needed. • Outcome Measure Data entry. • Cover administration desk when needed. Prioritize clients, telephone calls, scan, fax, copies staff requests. Secondary Functions Performs other assignments under the direction of the Division Director. Minimum Qualifications – Knowledge, Skills and Abilities Required • Bilingual – Spanish • High school diploma or educational equivalent. • 1 year of administrative experience • Verification of Employment and background check required. • TB Test required (new hires not more than 3 months prior to or 7 days after date of hire, and renewed annually thereafter). • Type 30-35 wpm, and proficient in Excel, Word, and Internet. • Ability to develop and maintain positive working relations with staff and management and other community agencies. • Ability to interact and communicate in a professional and positive fashion with the general public as well as with co-workers. • Ability to exercise good judgment in making decisions. • Ability to work in a timely and efficient manner. • Ability to meet assigned program goals and manage deadlines. • Ability to work independently with minimum supervision as well as part of a team. • Regular attendance required. • CPR and First Aid Certification required. • Valid California driver•s license, reliable transportation, and auto insurance required. Non Essential Qualifications (optional) • Desired knowledge, skills, and abilities • Medical billing experience. • Medical billing terminology. • Data entry experience. • Medical record charts. • Telephone communications, • 10-key by touch. • Ability to perform duties on evenings, weekends, and holidays may be required.Field Shared Notes:Must have vaccination and booster AppleOne is proud to be an Equal Opportunity Employer. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment qualified applicants with arrest and conviction records.
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, , , Email Resume to : emmelinep@ain1.com