Billing Specialist II (Verification of Benefits)

We are a premier provider dedicated to healing children and young adults, strengthening families, and transforming communities through quality comprehensive services and advocacy. We envision a world in which children and young adults, families, and communities are able to heal, grow, and thrive.

Job Type: Full-time Opportunity with Flexible Scheduling
Salary Range: $23 - $27 per hour, DOE

Office Location: Pasadena, CA

What We Offer:

An outstanding benefits package and numerous opportunities for career growth and advancement within our organization.

  • 13 Paid Holiday per year including Cesar Chavez & Juneteenth, earn up to 22 days of PTO
  • Flexible work schedule
  • Opportunity to gain extensive work experience as a clinician working with children & families
  • Robust training opportunities: Evidence Based Practices, Shared Core Practice Model & Trauma Informed Care.
  • Working with multi-disciplinary teams.
  • This role is eligible for Public Service Loan Forgiveness (PSLF)
  • Supervision available for Licensure.
  • Working with multi-disciplinary teams.
  • Medical insurance offering 3 HMO with Kaiser and Health Net, and also a PPO Plan
  • Dental insurance both HMO & PPO options, with 100% employer paid for HMO employee only coverage plan
  • Life and AD&D insurance 100% employer paid up to two times the annual salary
  • Long Term Disability
  • Flexible Spending Account for Medical and Dependent Care
  • 401(k) with no wait period and no vesting schedule 
  • 401(k) matching
  • Employee Assistance Program

The essential functions include:

  • Demonstrate proficiency in verifying insurance benefits to ensure accurate and timely processing of claims
  • Efficiently complete prior authorizations and conduct concurrent reviews, ensuring adherence to established protocols and guidelines
  • Skillfully address and resolve insurance-related issues, demonstrating a comprehensive understanding of insurance cards, insurance benefits, medical terminology, CPT/HCPCS and ICD-10 coding
  • Proactively liaise with insurance companies to track documentation, ensuring the initiation and progress of prior authorizations and/or gap exceptions from contracted health plans
  • Actively participate in peer-to-peer reviews, collaborating with relevant stakeholders
  • Consult with clinical program to guarantee the completeness of documentation for utilization reviews, maintaining a high standard of accuracy and compliance
  • Support patients throughout the billing and onboarding process,
  • Field patient complaints and questions
  • Utilize tools and resources to accurately estimate reimbursements and offer well-informed policy recommendations
  • Appropriately document all correspondence with clients and third-party insurances, ensuring a thorough and organized record-keeping process
  • Other duties as required

EDUCATION, EXPERIENCE & CERTIFICATES 

  • Minimum 2 years' experience in Medical Billing
  • Minimum 1 year experience in Verification of Benefits
  • High School Diploma or equivalent required 

TRAUMA INFORMED CARE (TIC)

Hillsides practices Trauma Informed Care (TIC) principles which recognizes the signs, symptoms, and widespread impact of trauma; Employees are asked to comprehensively integrate knowledge of Trauma Informed Care into policies, procedures, and practices with the goal to prevent re-traumatization which promotes healing of families, youth, individuals, and communities.

Seat 951