Health Care Billing Clerk II (1636) - Dept. of Public Health - (H00077)

DataSF • San Francisco, CA, United States • $200k - $250k / year • 3m ago

Health Care Billing Clerk II (1636) - Dept. of Public Health - (H00077)

Recruitment: REF41219Z

Published: July 12, 2024

Accepting applications until: July 12, 2024

The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in its workforce. All employees at the Department of Public Health work to advance equity, inclusion, and diversity with a specific lens and focus on race, ethnicity, gender, sex, sexuality, disability, and immigration status.

Under general supervision, the 1636 Health Care Billing Clerk II processes difficult and complex medical claims to Medicare, Medi-Cal, Commercial and third-party payers for services provided to patients by the Departments of Public Health. This classification is the journey-level class in the series responsible for performing the full range of duties.

The 1636 Health Care Billing Clerk II performs the following essential job functions:

Processes bills and claims for services rendered to patients in order to obtain reimbursement from Medicare, Medi-Cal, commercial, and third-party payors based upon current governmental billing rules and regulations;
Evaluates billing documents and claims data for accuracy, completeness, and program compliance;
Prepares the initial claims and the follow-up claim if necessary by categorizing charges according to the types of medical services provided, completing medical information, verifying that all charges relate to the diagnosis and calculating the charges and benefits according to regulations;
Spends down Medi-Cal share of cost in order to certify monthly coverage to allow processing of claims;
Posts payments received from various payors, including Medicare, Medi-Cal, commercial, and third-party payors;
Sends Claims Inquiry Forms (CIFs), appeals, and tracers on unpaid accounts at predetermined intervals;
Researches questions and denials and provides assistance to patients, physicians, insurance and legal representatives, fiscal intermediaries and others regarding claims reimbursement and coverage;
Produces reports relevant to billing and claims activities using electronic databases.

The 1636 Health Care Billing Clerk II also performs other related duties as required.

How to qualify

Minimum Qualifications - Required

EXPERIENCE: One (1) year of experience billing, claims processing and/or collecting healthcare services reimbursements or medical claims from Medi-Cal (Medicaid), Medicare, insurance, third party payors, and individual payors in a hospital, healthcare agency, or healthcare billing organization.

Substitution: Completion of 15 semester units or 22 quarter units of medical billing related coursework from an accredited college or university may substitute for six (6) months of qualifying experience.

Applicants must meet the minimum qualification requirement by the final filing date unless otherwise noted.

Important Note: Please make sure it is absolutely clear in your application exactly how you meet the minimum qualifications. Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process.

Selection Procedures

After application submission, candidates deemed qualified must complete all subsequent steps to advance in this selection process, which includes the following:

Minimum Qualification Supplemental Questionnaire (MQSQ) (Weight: Qualifying): Candidates will be required to complete an MQSQ as part of the employment application. This MQSQ is designed to obtain specific information regarding an applicant's experience in relation to the Minimum Qualifications (MQ) for this position.
Written Examination (Weight: 100%): Candidates must achieve a passing score on the written multiple-choice exam in order to continue in the selection process and will be placed on the confidential eligible list in rank order according to their final score.

Additional selection processes may be conducted by the hiring department prior to making final hiring decisions.

What else should I know?

How to apply: Applications for City and County of San Francisco jobs are only accepted through an online process. Visit careers.sf.gov and begin the application process.

CONDITION OF EMPLOYMENT: All City and County of San Francisco employees are required to be fully vaccinated against COVID-19 as a condition of employment. Someone is fully vaccinated when 14 days have passed since they received the final dose of a two-shot vaccine or a dose of a one-shot vaccine. Any new hire must present proof of full vaccination status to be appointed.

The City and County of San Francisco encourages women, minorities and persons with disabilities to apply. Applicants will be considered regardless of their sex, race, age, religion, color, national origin, ancestry, physical disability, mental disability, medical condition, HIV/AIDS status, genetic information, marital status, sexual orientation, gender, gender identity, gender expression, military and veteran status, or other protected category under the law.

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