Job Description

Billing Specialist

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Summary:

Performs billing and account activities to ensure compliant claims are submitted to payors to promote prompt payment. Reaches out to departments and HIM to confirm modifiers and resolve CCI and any other edits. Timely follow up on any billing related work queues. Acts as a resource for billing associates for more complex claims. Checks own works and possibly the work of others. Acts as subject matter expert and conducts training.

Job Requirements:

Education and Work Experience:

• High School Education/GED or equivalent: Preferred
• Associate's/Technical Degree or equivalent combination of education/related experience: Preferred
• Five years' medical billing experience: Preferred

Licenses/Certifications:

• Medical Billing or Accounting certification: Preferred

Essential Functions:

• Reviews, corrects and submits claims to payers. Acts as the billing systems super user. Meets and exceeds corporate clean claims standards. Provides guidance to staff within the latitude of established work area and policies. Works on assignments that are considerably difficult requiring judgment in resolving issues or in making recommendations. Works with sensitive and confidential information, often involving the interpretation of policies and procedures to guide use.
• Resolves discrepancies and processes and adjustments as needed. Runs and distributes reports to appropriate personnel. Identifies and flags problem accounts for intervention. Tracks and trends payer claims issues. Drives clean claims performance.
• Generates, reviews and distributes department reports. Ensures completion, accuracy, and clarity of all billing requirements. Keeps confidential all financial and accounting records. Provides communication regarding accounts in a timely and professional manner.
• Helps coordinate staff scheduling. Assists with new-employee orientation and staff education and training as needed. Advises on selection process of potential employees.
• Collaborates with other departments to resolve issues, share ideas and make procedural improvements. Assists with distribution of work queues.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

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