Hybrid Medicare and Medi-Cal Biller bei Self-Help for the Elderly

Title:        Medicare and Medi-Cal Biller

Department:    Administration – Finance and HCH

FLSA Status:    Non-Exempt

Reports To:    CFO and Administrator of HCH

Summary:    Responsible for the MSSP (Multipurpose Senior Services Program) billing and follow-up collections of all claims and taking actions as needed to ensure full payment for services rendered and Financial Reporting to CDA. Also, assists with the Home Care and Hospice billing and coding.

Essential Functions:

⦁  Completes all claims billing for MSSP services, including Care Management, Care Support and Waiver Services.

⦁  Monitors and reviews all Waiver Services provided to the clients.

⦁  Conducts pre-billing audits to ensure the accuracy of documentation.

⦁  Generates reports at the end of month close reflecting revenues, expenses, and accounts receivable and collections.

⦁  Generates reports for CDA – monthly, quarterly and annually per CDA requirement.

⦁  Communicates with the MSSP Team for all billing issues.

⦁  Verifies Medi-Cal eligibility for new referrals when requested.

⦁  Manages vendor contracts from contract creation through execution and contract renewal.

⦁  Conducts ongoing analysis to ensure proper vendor performance and cost utilization.

⦁  Communicate and coordinate with HCH/HH department team for coding and billing needs.

⦁  Perform assessments of HCH/HH coding 

⦁  Attend the HCH/HH department's admin meeting and collaborate with the team for business development.

⦁  Assists with Fiscal audits and CDA audits.

⦁  Attends department and agency meetings.

⦁  Assists with counting Nutrition Dept Meal Contributions.

⦁  Performs other duties.

Qualifications:

⦁  Prior experience in Medi-Cal billing, eligibility verification, and claim status is preferred.

⦁  Associate degree with an emphasis in Medi-Cal billing, Medi-Cal coding, health information management, or a related field. May be substituted with one year of task-specific experience. 

⦁  Great attention to detail, good organizational skills, and ability to manage and prioritize multiple tasks in a fast-paced environment.

⦁  Excellent verbal and written communication skills and demonstrated business telephone skills.

⦁  Proficient in MS Office and the Internet.

⦁  Must pass a background check.

Self-Help for the Elderly is an Equal Employment Opportunity/Affirmation Action Employer and we welcome diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, age, national origin, sexual orientation, disability, protected veteran status or any other characteristics protected by law. We participate in E-Verify.

Qualified applicants with criminal history will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.

We may provide reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please call (415) 677-7600 for special assistance.