Ventura County
Medical Billing Specialist III/IV - Behavioral Health
Ventura County, Ventura, California, United States
Overview
THE POSITION: Under general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements. Ideal Candidate
The ideal candidate has specialized expertise in mental health billing, including CPT, ICD-10, and HCPCS coding for Medicare and Medi-Cal. They are skilled in the Medi-Cal Provider Manual and TAR process, ensuring timely, compliant submissions that support access to behavioral health services. They communicate effectively with peers, patients, and payers, resolve billing discrepancies, and address compliance issues in collaboration with the compliance office. They have experience in leading and training staff on Managed Care, Medicaid, Medi-Cal, Medicare, and Commercial Insurance, and ensure accuracy, efficiency, and regulatory adherence in all mental health billing operations. Medical Billing Specialist III (\u0024 25.10 - 31.86 per hour) is the advanced-journey level class performing more complex work involving extensive analysis and research through the use of multiple electronic health record (EHR) systems such as Cerner, HURON, and/or Claim Source to follow up on accounts. Medical Billing Specialist IV (\u0027\u0027) (\u0024 27.86 - 35.37 per hour) is the lead level class and serves as technical advisor to lower-level Medical Billing Specialists. In addition to performing advanced-journey billing work, incumbents perform program administrative duties to assure that all claims are billed timely. What We Offer
The County of Ventura offers an attractive compensation and benefits package that includes: Merit Increases
- New employees are eligible for an initial 5% merit increase within the pay range after 1,040 hours (~6 months) of satisfactory work. Subsequent merit increases occur after each additional 2,080 hours (~one year). Educational Incentive
- 2.5% for an associate\'s degree, 3.5% for a bachelor\'s degree, or 5% for a graduate degree. Bilingual Incentive
- Based on agency need: $0.69/hr (Level I), $1.00/hr (Level II), or $1.32/hr (Level III). Vacation Accrual
- Approximately 14 days/year for the first 5 years; increases with years of service up to 26 days/year. Vacation Leave Redemption
- After 14,560 hours, up to 80 hours may be redeemed in the same year after using 80 hours in the preceding 12 months. Sick Leave
- 3.08 hours per bi-weekly pay period; an advance of 40.04 hours at hire. Deferred Compensation
- Eligible for County 401(k) and/or 457 plans; up to 3.00% match. Health Plans
- Flexible credit allowance up to $21,450 annually for medical/dental/vision; detailed contribution amounts per family status provided by plan. Flexible Spending Accounts
- Pre-tax benefits for eligible medical, dental, vision, and dependent care. Pension Plan
- Participation in the County\'s defined pension plan with reciprocity with CalPERS. Holidays
- 12 paid days per year including a floating holiday. Additional Benefits
- Tuition reimbursement, disability plans, EAP, life insurance, wellness program. Agency/Department:
Health Care Agency - Ventura County Behavioral Health (VCBH). Medical Billing Specialist III/IV are represented by SEIU and are eligible for overtime. The eligible list established from this recruitment may be used to fill current and future Regular, Intermittent, and Extra-Help vacancies. There are currently three Regular vacancies in Ventura County Behavioral Health. Note: If appointed at the lower level, incumbents may be promoted to the higher level without further exam upon meeting minimum requirements and department needs. Tentative Schedule : Open date 8/27/25; Closing date: Continuous and may close at any time. Apply as soon as possible. Duties and Responsibilities
Duties may include but are not limited to: Review and analyze bills as they come off the system and transmit them to the appropriate intermediary in a timely manner. Ensure accuracy and compliance with billing, coding, and follow-up requirements; identify overpayments and documentation issues. Maintain work queue with backlog up to 46 hours of receipt. Review and follow up on denial codes for potential reimbursement. Provide information to payors and ensure reimbursement is received. Gather, compile, and analyze billing and statistics; prepare bills and transmit on time. Provide advanced-level billing and supervision as a lead for Medicare and/or Medi-Cal. Review submittals for accurate transmission and timely payment; monitor new Medi-Cal and/or Medicare programs and prepare reports. Serve as lead biller/specialist to the department; perform other related duties as required. Medical Billing Specialist IV — Additional Duties : Advises management on reducing days in accounts receivable for Medicare/Medi-Cal; develop trainings for staff in registration and billing; supervise or conduct trainings in Managed Care/Medicaid/Medi-Cal/Medicare/Commercial Insurance; coordinate workflow integration. Education, Training, and Experience
Any combination of education and experience that provides the required knowledge, skills, and abilities. Typical knowledge is obtained through hands-on experience in a medical complex similar to VCBH. Medical Billing Specialist III: three (3) years of professional billing experience including preparation of financial statements OR two (2) years as Medical Billing Specialist II for the County of Ventura. Medical Billing Specialist IV: four (4) years of professional billing experience OR one (1) year as Medical Billing Specialist III for the County of Ventura. Desired
Associate\'s or Bachelor\'s degree in a business-related field Medical billing experience within a behavioral health organization Basic proficiency in MS Excel Experience in Managed Care and Commercial Insurance billing Experience with multiple EHR systems (Cerner, HURON, Claim Source) Supervisory experience Knowledge, Skills, and Abilities
Knowledge of: Medical reimbursement programs and complex payment systems CPT, ICD-10, HCPCS codes for Medicare/Medi-Cal Medi-Cal Provider Manual for Billing and Policy and Program and Eligibility TAR process Ability to: Communicate openly with peers, managers, patients, and payers Process bills accurately and obtain prompt reimbursements Research accounts for overcharges and payment methodologies Evaluate compliance and work with the compliance office to resolve regulatory conflicts At the MBS IV level, lead billers and conduct trainings on Managed Care/Medicaid/Medi-Cal/Medicare/Commercial Insurance Final Filing Date
This is a continuous recruitment and may close at any time; apply as soon as possible. Applications must be received by 5:00 p.m. on the closing date. Note: Previous closing date was September 17, 2025. How to Apply
To apply online, visit www.venturacounty.gov/jobs. For paper applications, call (805) 677-5184 for materials and submit to County of Ventura Human Resources - Health Care Agency, 646 County Square Drive, Ventura, CA 93003. Note to Applicants:
Complete all sections of the application and supplemental questionnaire thoroughly. A resume may be attached to supplement responses but may not substitute for the application. Additional Information
Lateral Transfer Option:
If presently employed in another merit or civil service position, lateral transfer may be possible. Click here for more information. Supplemental Questionnaire – qualifying:
All applicants must complete and submit the questionnaire. Failure to do so may remove you from consideration. Application Evaluation – qualifying:
All applications reviewed to determine meeting stated requirements; qualified individuals invited to continue in process. Training & Experience Evaluation (T&E) – 100%:
Structured evaluation of application materials. May be used to rank candidates. An oral exam may be used in the process depending on the pool size. Supplemental questions should be completed with care. Oral Examination – 100%:
If used, must earn 70% or higher to qualify. The process may replace with T&E depending on pool size. Background Investigation:
May be required pre-employment/post-offer. Equality:
The County of Ventura is an equal opportunity employer. Questions: Nathan Wood at nathan.wood@ventura County.gov or (805) 677-5232.
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THE POSITION: Under general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements. Ideal Candidate
The ideal candidate has specialized expertise in mental health billing, including CPT, ICD-10, and HCPCS coding for Medicare and Medi-Cal. They are skilled in the Medi-Cal Provider Manual and TAR process, ensuring timely, compliant submissions that support access to behavioral health services. They communicate effectively with peers, patients, and payers, resolve billing discrepancies, and address compliance issues in collaboration with the compliance office. They have experience in leading and training staff on Managed Care, Medicaid, Medi-Cal, Medicare, and Commercial Insurance, and ensure accuracy, efficiency, and regulatory adherence in all mental health billing operations. Medical Billing Specialist III (\u0024 25.10 - 31.86 per hour) is the advanced-journey level class performing more complex work involving extensive analysis and research through the use of multiple electronic health record (EHR) systems such as Cerner, HURON, and/or Claim Source to follow up on accounts. Medical Billing Specialist IV (\u0027\u0027) (\u0024 27.86 - 35.37 per hour) is the lead level class and serves as technical advisor to lower-level Medical Billing Specialists. In addition to performing advanced-journey billing work, incumbents perform program administrative duties to assure that all claims are billed timely. What We Offer
The County of Ventura offers an attractive compensation and benefits package that includes: Merit Increases
- New employees are eligible for an initial 5% merit increase within the pay range after 1,040 hours (~6 months) of satisfactory work. Subsequent merit increases occur after each additional 2,080 hours (~one year). Educational Incentive
- 2.5% for an associate\'s degree, 3.5% for a bachelor\'s degree, or 5% for a graduate degree. Bilingual Incentive
- Based on agency need: $0.69/hr (Level I), $1.00/hr (Level II), or $1.32/hr (Level III). Vacation Accrual
- Approximately 14 days/year for the first 5 years; increases with years of service up to 26 days/year. Vacation Leave Redemption
- After 14,560 hours, up to 80 hours may be redeemed in the same year after using 80 hours in the preceding 12 months. Sick Leave
- 3.08 hours per bi-weekly pay period; an advance of 40.04 hours at hire. Deferred Compensation
- Eligible for County 401(k) and/or 457 plans; up to 3.00% match. Health Plans
- Flexible credit allowance up to $21,450 annually for medical/dental/vision; detailed contribution amounts per family status provided by plan. Flexible Spending Accounts
- Pre-tax benefits for eligible medical, dental, vision, and dependent care. Pension Plan
- Participation in the County\'s defined pension plan with reciprocity with CalPERS. Holidays
- 12 paid days per year including a floating holiday. Additional Benefits
- Tuition reimbursement, disability plans, EAP, life insurance, wellness program. Agency/Department:
Health Care Agency - Ventura County Behavioral Health (VCBH). Medical Billing Specialist III/IV are represented by SEIU and are eligible for overtime. The eligible list established from this recruitment may be used to fill current and future Regular, Intermittent, and Extra-Help vacancies. There are currently three Regular vacancies in Ventura County Behavioral Health. Note: If appointed at the lower level, incumbents may be promoted to the higher level without further exam upon meeting minimum requirements and department needs. Tentative Schedule : Open date 8/27/25; Closing date: Continuous and may close at any time. Apply as soon as possible. Duties and Responsibilities
Duties may include but are not limited to: Review and analyze bills as they come off the system and transmit them to the appropriate intermediary in a timely manner. Ensure accuracy and compliance with billing, coding, and follow-up requirements; identify overpayments and documentation issues. Maintain work queue with backlog up to 46 hours of receipt. Review and follow up on denial codes for potential reimbursement. Provide information to payors and ensure reimbursement is received. Gather, compile, and analyze billing and statistics; prepare bills and transmit on time. Provide advanced-level billing and supervision as a lead for Medicare and/or Medi-Cal. Review submittals for accurate transmission and timely payment; monitor new Medi-Cal and/or Medicare programs and prepare reports. Serve as lead biller/specialist to the department; perform other related duties as required. Medical Billing Specialist IV — Additional Duties : Advises management on reducing days in accounts receivable for Medicare/Medi-Cal; develop trainings for staff in registration and billing; supervise or conduct trainings in Managed Care/Medicaid/Medi-Cal/Medicare/Commercial Insurance; coordinate workflow integration. Education, Training, and Experience
Any combination of education and experience that provides the required knowledge, skills, and abilities. Typical knowledge is obtained through hands-on experience in a medical complex similar to VCBH. Medical Billing Specialist III: three (3) years of professional billing experience including preparation of financial statements OR two (2) years as Medical Billing Specialist II for the County of Ventura. Medical Billing Specialist IV: four (4) years of professional billing experience OR one (1) year as Medical Billing Specialist III for the County of Ventura. Desired
Associate\'s or Bachelor\'s degree in a business-related field Medical billing experience within a behavioral health organization Basic proficiency in MS Excel Experience in Managed Care and Commercial Insurance billing Experience with multiple EHR systems (Cerner, HURON, Claim Source) Supervisory experience Knowledge, Skills, and Abilities
Knowledge of: Medical reimbursement programs and complex payment systems CPT, ICD-10, HCPCS codes for Medicare/Medi-Cal Medi-Cal Provider Manual for Billing and Policy and Program and Eligibility TAR process Ability to: Communicate openly with peers, managers, patients, and payers Process bills accurately and obtain prompt reimbursements Research accounts for overcharges and payment methodologies Evaluate compliance and work with the compliance office to resolve regulatory conflicts At the MBS IV level, lead billers and conduct trainings on Managed Care/Medicaid/Medi-Cal/Medicare/Commercial Insurance Final Filing Date
This is a continuous recruitment and may close at any time; apply as soon as possible. Applications must be received by 5:00 p.m. on the closing date. Note: Previous closing date was September 17, 2025. How to Apply
To apply online, visit www.venturacounty.gov/jobs. For paper applications, call (805) 677-5184 for materials and submit to County of Ventura Human Resources - Health Care Agency, 646 County Square Drive, Ventura, CA 93003. Note to Applicants:
Complete all sections of the application and supplemental questionnaire thoroughly. A resume may be attached to supplement responses but may not substitute for the application. Additional Information
Lateral Transfer Option:
If presently employed in another merit or civil service position, lateral transfer may be possible. Click here for more information. Supplemental Questionnaire – qualifying:
All applicants must complete and submit the questionnaire. Failure to do so may remove you from consideration. Application Evaluation – qualifying:
All applications reviewed to determine meeting stated requirements; qualified individuals invited to continue in process. Training & Experience Evaluation (T&E) – 100%:
Structured evaluation of application materials. May be used to rank candidates. An oral exam may be used in the process depending on the pool size. Supplemental questions should be completed with care. Oral Examination – 100%:
If used, must earn 70% or higher to qualify. The process may replace with T&E depending on pool size. Background Investigation:
May be required pre-employment/post-offer. Equality:
The County of Ventura is an equal opportunity employer. Questions: Nathan Wood at nathan.wood@ventura County.gov or (805) 677-5232.
#J-18808-Ljbffr