Illumination Foundation
Overview
Billing Claims Specialist Illumination Health + Home is a growing non-profit organization dedicated to disrupting the cycle of homelessness by providing targeted, interdisciplinary services across recuperative care centers, emergency shelters, housing services, and children and family programs. IF currently has 13+ facilities with 22+ micro-communities across Orange County, Los Angeles County, and the Inland Empire. The Billing Claims Specialist oversees the billing process for customers or patients, processes payments, maintains financial records, ensures accurate billing and claims submissions, keeps accounts receivable for CalAIM current, performs claim follow-up and escalation, and has knowledge of billing codes and standard procedures. The pay rate is $25-$27 per hour. Schedule: hybrid with Monday/Thursday in office and Tuesday/Wednesday/Friday WFH.
Responsibilities
Reviewing data and creating claims for services rendered
Ensuring claims meet the standards of our contracts and programs
Verifying authorizations via provider portals or authorization letters on Kipu prior to claim submission
Verifying eligibility prior to claim submission via provider or DHCS portals
Review client records to extract applicable data necessary for billing purposes, including ICD-10 codes and CPT codes for services rendered
Review and follow up on outstanding accounts receivable
Review any rejected or denied claims and conduct proper follow up procedures (escalations / appeals / claim corrections)
Monitor and maintain county aging and escalating trends, write-offs, etc.
Understand and read EOBs and Remittance Advice
Post payments accurately to claims and continue with the claim close-out process
Assist supervisors on billing-related projects as needed
Attend monthly team meetings or trainings at Corporate location
Communicate with tact and professionalism
Meet targets and work under pressure with a high volume of claims
Maintain knowledge of industry-standard CMS guidelines for Billing
Motivated to work independently as well as in a team
Minimum Qualifications / Preferred Experience
High School Diploma or equivalent
1-2 years' relevant experience
Basic computer skills, including email and data summarization in spreadsheets
Experience with Electronic Billing Platforms and EHR systems
Experience working with claims and communication with health networks
Proficiency in Microsoft Office (Mail, Word, Excel, Calendar)
Associate's degree or higher
Medical Billing Certificate
Experience in Medical Billing and Primary Care Billing
Benefits
Medical Insurance funded up to 91% by Illumination Health + Home (Kaiser and Blue Shield), depending on the plan
Dental and Vision Insurance
Life, AD&D and LTD Insurance funded 100% by Illumination Health + Home
Employee Assistance Program
Professional Development Reimbursement
401K with Company Matching
10 days vacation PTO per year
6 days of sick pay per year
Potential eligibility for the Public Service Loan Forgiveness Program (PSLF) for federally qualified loans
#J-18808-Ljbffr
Billing Claims Specialist Illumination Health + Home is a growing non-profit organization dedicated to disrupting the cycle of homelessness by providing targeted, interdisciplinary services across recuperative care centers, emergency shelters, housing services, and children and family programs. IF currently has 13+ facilities with 22+ micro-communities across Orange County, Los Angeles County, and the Inland Empire. The Billing Claims Specialist oversees the billing process for customers or patients, processes payments, maintains financial records, ensures accurate billing and claims submissions, keeps accounts receivable for CalAIM current, performs claim follow-up and escalation, and has knowledge of billing codes and standard procedures. The pay rate is $25-$27 per hour. Schedule: hybrid with Monday/Thursday in office and Tuesday/Wednesday/Friday WFH.
Responsibilities
Reviewing data and creating claims for services rendered
Ensuring claims meet the standards of our contracts and programs
Verifying authorizations via provider portals or authorization letters on Kipu prior to claim submission
Verifying eligibility prior to claim submission via provider or DHCS portals
Review client records to extract applicable data necessary for billing purposes, including ICD-10 codes and CPT codes for services rendered
Review and follow up on outstanding accounts receivable
Review any rejected or denied claims and conduct proper follow up procedures (escalations / appeals / claim corrections)
Monitor and maintain county aging and escalating trends, write-offs, etc.
Understand and read EOBs and Remittance Advice
Post payments accurately to claims and continue with the claim close-out process
Assist supervisors on billing-related projects as needed
Attend monthly team meetings or trainings at Corporate location
Communicate with tact and professionalism
Meet targets and work under pressure with a high volume of claims
Maintain knowledge of industry-standard CMS guidelines for Billing
Motivated to work independently as well as in a team
Minimum Qualifications / Preferred Experience
High School Diploma or equivalent
1-2 years' relevant experience
Basic computer skills, including email and data summarization in spreadsheets
Experience with Electronic Billing Platforms and EHR systems
Experience working with claims and communication with health networks
Proficiency in Microsoft Office (Mail, Word, Excel, Calendar)
Associate's degree or higher
Medical Billing Certificate
Experience in Medical Billing and Primary Care Billing
Benefits
Medical Insurance funded up to 91% by Illumination Health + Home (Kaiser and Blue Shield), depending on the plan
Dental and Vision Insurance
Life, AD&D and LTD Insurance funded 100% by Illumination Health + Home
Employee Assistance Program
Professional Development Reimbursement
401K with Company Matching
10 days vacation PTO per year
6 days of sick pay per year
Potential eligibility for the Public Service Loan Forgiveness Program (PSLF) for federally qualified loans
#J-18808-Ljbffr