Medical Billing Specialist

ABOUT MARINHEALTH
Are you looking for a place where you are empowered to bring innovation to reality? Join MarinHealth, an integrated, independent healthcare system with deep roots throughout the North Bay. With a world-class physician and clinical team, an affiliation with UCSF Health, an ever-expanding network of clinics, and a new state-of-the-art hospital, MarinHealth is growing quickly. MarinHealth comprises MarinHealth Medical Center, a 327-bed hospital in Greenbrae, and 55 primary care and specialty clinics in Marin, Sonoma, and Napa Counties. We attract healthcare’s most talented trailblazers who appreciate having the best of both worlds: the pioneering medicine of an academic medical center combined with an independent hospital's personalized, caring touch. 

MarinHealth is already realizing the benefits of impressive growth and has consistently earned high praise and accolades, including being Named One of the Top 250 Hospitals Nationwide by Healthgrades, receiving a 5-star Ranking for Overall Hospital Quality from the Centers for Medicare and Medicaid Services, and being named the Best Hospital in San Francisco/Marin by Bay Area Parent, among others. 

Company:

Prima Medical Foundation dba MarinHealth Medical Network

Work Shift:

8 Hour (days) (United States of America)

Scheduled Weekly Hours:

40

Job Description Summary:

The Billing Specialist is responsible for the coordination of full-scope for each assigned specialty. In conjunction with Practice Leaders ensures accurate charge capture and management of the reconciliation process. Daily review and working of revenue cycle work queues is essential. Communicates with coding vendor regarding surgical procedures. Trains support staff on appropriate billing procedures. Works with Revenue Cycle and Operation Directors on overall status of outstanding billing for these specialties.

Job Requirements, Prerequisites and Essential Functions:

Pay Range:
$23.00 - $27.40 - $31.73

Essential Functions and Responsibilities: 

• Effectively uses application of “Current Procedural Terminology” (CPT) coding system; interprets appropriately and accurately.
• Ensures clinical staff and providers submit proper and accurate documentation for the services being provided.
• Serves as a liaison/resource for clinical and non-clinical staff regarding revenue cycle processes.
• Responsible for completion of all claims and itemized bills daily, with complete accuracy.
• Responsible for the daily review of appropriate reports from Apex and reporting any discrepancies to the Practice Leader.
• Performs quality control functions on claims and itemized bills to ensure overall accuracy to assure prompt and correct payments.
• Fosters effective working relationships with external organizations and agencies as required.
• Responsible for maintaining a strong focus on assigned tasks and at all times being a strong team player.
• Ability to exercise initiative, decision-making, and problem solving. 
• Ability to manage multiple tasks in a busy clinical environment.
• Ability to prioritize tasks and manage time efficiently.
• Other duties as assigned

Qualifications:

• Strong interpersonal skills with ability to communicate in a clear and positive manner both verbally and in writing.
• Ability to read, understand, and follow oral and written instruction with attention to detail required.
• Ability to problem solve and monitor / track data, identify trends and create solutions.
• Understanding of insurance payors, prior authorizations and eligibility requirements.
• Knowledge of computer systems and applications, i.e. Microsoft Office, Excel, Word.

Licensure:

• Coding specialist certification preferred.

Education:

• High school diploma or General Education Degree (GED) required.

Experience:

• Minimum 3 years’ experience in medical billing.
• Experience in health care customer service.
• Experience with Apex/Epic preferred.
• Experience and current knowledge of ICD10CM, CPT, and HCPCS coding methods. Coding experience a plus.

Accommodation:

Qualified applicants with disabilities may request reasonable accommodation during the application process by contacting Human Resources at 415-925-7040 or [email protected].

C.A.R.E.S. Standards:

MarinHealth seeks candidates ready to model our C.A.R.E.S. standards—Communication, Accountability, Respect, Excellence, Safety—which foster a healing, trust-based environment for patients and colleagues.

Health & Immunizations:

To protect employees, patients, and our community, MarinHealth requires measles, mumps, varicella, and annual influenza immunizations as a condition of employment (and annually thereafter). COVID-19 vaccination/booster remains strongly recommended. Medical or religious exemptions will be considered consistent with applicable law.

Compensation:

The posted pay range complies with applicable law and reflects what we reasonably expect to pay for this role. Individual pay is set by skills, experience, qualifications, and internal/market equity, consistent with MarinHealth’s compensation philosophy. Positions covered by collective bargaining agreements are governed by those agreements.

Equal Employment:

All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sexual orientation, gender identity, protected veteran status or disability status, and any other classifications protected by federal, state, and local laws.