The Sr. Medical Billing Specialist is responsible for processing and submitting claims/bills to Medicare, third-party health plans and clients for services provided by HCA’s mental health and recovery as well as substance use disorder services, in compliance with state/federal regulations. The Sr. MBS communicates with culturally diverse clients in resolving past due accounts for mental health and substance use disorder services. Collaborates with HCA program employees in the recalculation of annual fees (Universal Method of Determining Ability to Pay - UMDAP) due to a change in the financial position of a client. Reconciles client accounts to accurately reflect the correct balance due once the UMDAP has been determined. Prepares supporting documents for small claims court. Acts as a representative in small claims court on behalf of Orange County Health Care Agency, answering questions presented by the judge or negotiates a settlement with the client, prior to the hearing. The Sr. Medical Billing Specialist will perform claims follow up duties; researching claims not paid or underpaid claims, taking actions necessary. All HCA Accounting positions are assigned to the Auditor-Controller’s satellite accounting team at the Health Care Agency.
Location: Orange County, CA