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Office Assistant Specialist- Billing SJGH

Recruitment #1216-RO6115-T1

Introduction

This examination is being given to fill two (2) temporary vacancies in the San Joaquin General Hospital's Patient Accounting Department and to establish a temporary and part-time referral pool to fill future vacancies. Resumes will not be accepted in lieu of an application. A completed application must be postmarked or received online by the final filing deadline.

The Position

The Office Assisant Specialist (Biller) assigned to the Patient Accounting Department will be responsible for hospital institutional, outpatient billing, and reimbursement.  The incumbent will be responsible for submitting claims for reimbursement of patient charges to various parties, inlcuding Medi-Cal, Medicare, and insurance companies.  The ideal candidate will have knowledge of basic medical terminology, electronic medical bililng practices, procedures and codes, institutional billing and hospital physician and outpatient procedures and services required. 

The Department

San Joaquin General Hospital is a public hospital and designated level III Trauma Center. The hospital, originally established in 1857, is a 196-bed general acute care facility providing a full range of both inpatient and outpatient services. SJGH's friendly staff works hard to provide the highest quality care services to the residents of San Joaquin County.

To learn more about the department, visit:  www.sjgeneral.org 

NOTE: All correspondences relating to this recruitment will be delivered via e-mail. The e-mail account used will be the one provided on your employment application during time of submittal. Please be sure to check your e-mail often for updates. If you do not have an e-mail account on file, Human Resources will send you correspondences via US Mail.

 

 

TYPICAL DUTIES

Reviews accounts for accurate billing information including required patient and payer specific documentation and charges.  Determines when accounts are billable.  Ascertains that the proper authorizations were obtained per various payer and utilization review guidelines and that the length of stay matches approved and denied days.

Reviews claims by accessing the most current version of the UB and CMS 1500 editors.

Processes claims either electronically to Medicare, Medi-Cal, Managed Care, Commercial payers or queue to print accurately to intermediaries and/or third parties according to applicable rules and regulations based on payer and Business Office protocols.

Generates claims for such special circumstances as "stop less," interim or cycle bills or other payer driven provisions.

Processes late charges after determining the impact on reimbursement.

Bills "stop less" accounts and individual contract accounts according to department policy as well as insurance/government contract provisions.

Provides timely and effective follow-up and resolution on unpaid, underpaid and overpaid government, third party, and patient balances through the use of the Aged Trial Balance reports, tickler files, and directives from Supervisor or Manager.

Performs various patient account maintenance functions, such as refunds, adjustments, transfers between accounts, address changes, etc.

Analyzes the transaction to identify and process corrections for errors for omissions made in the processing of payment and adjustments.

Analyses and determines who should receive the refund(s) and the amount(s) and prepares a refund request for supervisory approval and submission Accounts Payable for processing.

Serves as a resource to patients, payers, peers and other departments in the processing and resolution of billing related functions and tasks.

Performs other related work as required/assigned.

MINIMUM QUALIFICATIONS

Note: The following special requirements were approved by the Civil Service Commission on October 12, 2016.

Note:  Supplemental application must be submitted with employment application.

 

Either I

Experience:  One year of work at a level equal to or higher than Senior Office Assistant in San Joaquin County service which include electronic billing and follow-up in a medical or healthcare setting.

 

Or II

Experience:  Three years of experience performing medical billing, including at least two years of functioning at a full-journey level performing Medi-Cal and/or Medicare electronic billing for a hospital or a high volume professional practice. 

KNOWLEDGE

Billing and collection rules and regulations including Medicare, Medi-Cal, insurance companies; knowledge of basic arithmetic; bookkeeping and account reconciliation procedures and techniques, general hospital operations and busienss practices, correspondence and documentation procedures; knowledge of computer-based patient accounting management systems; knowledge of medical terminology and familiarity with current diagnostic and procedure coding.

ABILITY

Research, interpret and apply complex laws/regulations; third-party reimbursement rules/requirements related to hospital patient accounting practices and procedures; evaluate and establish priorities; gather, organize, input and maintain complex information; follow complex oral and writen procedures and directions; establish and maintain effective working relationships with others; communicate effectively with others; write clearly and legibly; perform advanced arithmetical operations; may train, lead or supervisor others.

PHYSICAL/MENTAL REQUIREMENTS

Mobility-Frequent operation of a data entry device, repetitive motion, sitting for long periods, walking; occasional standing, pushing, pulling, bending, squatting, climbing; Lifting-Frequently 5 pounds or less; occasionally 5 to 30 pounds; Visual-Constant good overall vision and reading/close-up work; frequent color perception and use of eye/hand coordination; occasional use of depth perception and peripheral vision; Hearing/Talking-Frequent hearing of normal speech, hearing/talking on the telephone, talking in person; Emotional/Psychological-Frequent decision making, concentration, and public contact; Special Requirements-Some assignments may require working weekends, nights, and/or occasional overtime; Environmental-Occasional exposure to varied weather conditions.

Selection Procedures

Applicants for part-time and temporary recruitments who meet the minimum qualifications are either referred to the hiring department for further selection or they may be required to take a written examination.  If a written examination is given, the top candidates may be referred to the hiring department for further selection.

Testing Accommodation:  Candidates who require testing accommodation under the Americans with Disabilities Act (ADA) must call Human Resources Division at (209) 468-3370 prior to the examination date. 

Physical Exam:  Some classifications require physical examinations.  Final appointment cannot be made until the eligible has passed the physical examination.  The County pays for physical examinations administered in its medical facilities.

Pre-employment Drug Screening Exam:  Some classifications require a new employee successfully pass a pre-employment drug screen as a condition of employment.  Final appointment cannot be made until the eligible has passed the drug screen.  The County pays for the initial drug screen.

Employment of Relatives: Applicants who are relatives of employees in a department within the 3rd degree of relationship, (parent, child, grandparent, grandchild or sibling) either by blood or marriage, may not be appointed, promoted, transferred into or within the department when:

  • They are related to the Appointing Authority, or

  • The employment would result in one of them supervising the work of the other

Department Heads may establish additional limitations on the hiring of relatives by departmental rule.

Proof of Eligibility:  If you are offered a job, you will be required to provide proof of U.S. citizenship or other documents that establish your eligibility to be employed in the U.S.

HOW TO APPLY

Apply Online:       

www.sjgov.org/hr

By mail or in person:  

San Joaquin County Human Resources

44 N. San Joaquin Street Suite 330

Stockton, Ca 95202                                  

 

Office hours:               
Monday – Friday 8:00 am to 5:00 pm; excluding holidays.

Phone:  (209) 468-3370 

 

Job Line:

For current employment opportunities please call our 24-hour job line at (209) 468-3377. 

When a final filing date is indicated, applications must be filed with the Human Resources Division before 5:00 p.m. or postmarked by the final filing date. Resumes will not be accepted in lieu of an application. Applications sent through county inter-office mail, which are not received by the final filing date, will not be accepted. (The County assumes no responsibility for mailed applications which are not received by the Human Resources Division).  

San Joaquin County Substance Abuse Policy: San Joaquin County has adopted a Substance Abuse Policy in compliance with the Federal Drug Free Workplace Act of 1988. This policy is enforced by all San Joaquin County Departments and applies to all San Joaquin County employees.

Equal Opportunity Employer:  San Joaquin County is an Equal Employment Opportunity (EEO) Employer and is committed to providing equal employment to all without regard to age, ancestry, color, creed, marital status, medical condition, national origin, physical or mental disability, political affiliation or belief, pregnancy, race, religion, sex, or sexual orientation.  For more information go to
www.sjgov.org/eeo.




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San Joaquin County
Human Resources Division  Stockton, CA 95202
E-mail | Phone: (209) 468-3370 | 8am - 5pm M-F | Powered by JobAps