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Job Title:
Claims and Billing Analyst
Division/Program:
Long Beach Corporate Office
Starting Compensation:
30.00 to 31.00 USD Per Hour
Working Location:
Long Beach, CA (Hybrid)
Working Hours/Shift:
Monday - Friday (9:00 AM - 5:30 PM)
What SBHG brings to you (benefits):
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Competitive compensation
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Company paid benefits package including medical, dental and vision and many other voluntary benefits for employees
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Generous vacation and holiday pay
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On the job training including paid CEU opportunities and career development
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AMFT, ACSW and APCC’s receive supervision for BBS hours (when applicable)
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Click here to learn more: https://www.starsinc.com/careers/employee-benefits
What you bring to SBHG (Qualifications):
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Bachelor's degree in healthcare administration, finance, or a related field preferred
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Experience in claims processing, reporting, and analysis
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Proficiency in data manipulation and analysis tools, such as Microsoft Excel, SQL, or similar software.
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A strong understanding of Electronic Medical Record (EMR) systems and healthcare billing processes is a plus.
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Excellent problem-solving skills and attention to detail.
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Ability to work independently and collaboratively in a fast-paced environment.
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Effective communication skills, with the ability to interact with diverse stakeholders including healthcare providers, county agencies, and insurance companies.
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Knowledge of healthcare regulations and compliance requirements is preferred.
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Experience with Resource and Provider Profiling (RPP) systems is a plus.
How you will make a difference (Job Overview):
We seek a highly skilled and detail-oriented Healthcare Claims Reporting and Analysis Specialist to join our team. The ideal candidate will possess a robust background in healthcare administration, proficient in data analysis, and reporting, with a specific emphasis on claims processing and financial reconciliation. The primary responsibilities for this role include generating, analyzing, and reconciling various reports related to claims, while also troubleshooting client enrollment and billing issues utilizing county and Electronic Medical Record (EMR) data.
Division/Program Overview:
Produce claiming-related reports using LA County SIFT files and concatenate EMR and County data as needed for accuracy. Coordinate with EMR systems for finance-related changes and troubleshoot client enrollment and claiming issues using county and EMR data. Procure data from LA County Provider Connect for authorization-related troubleshooting, with potential expansion to other counties. Interacted with RPP entities as necessary and prepared comprehensive reports on billing, held claims, and unbilled services. Generate automated billing files for flat file-claiming counties like Sacramento and San Bernardino and prepare reports based on client eligibility files. Develop processes to reconcile general ledger expenses and prepare ad hoc reports for finance and revenue verification. Collaborate with billing staff to identify and troubleshoot denials and billing issues, providing data to support contract review for accurate reimbursement from County and private insurance contracts.
Learn more about SBHG at: https://www.starsinc.com/stars-inc/
For Additional Information:
Kijones@starsinc.com
SBHG and its affiliates acknowledge all COVID 19 vaccination guidelines and mandates recommended by the State of California Department of Public Health. For more details, please see: https://covid19.ca.gov/workers-and-businesses/#vaccination-testing-requirements
Grade State Range: 24.84 - 39.74 USD Hourly