Search Jobs
Medical Billing Analyst
2550 W Clinton Ave #142 fresno, CA 93705 US
Job Description
Hire Up Staffing is seeking a Medical Billing Analyst to ensure the accuracy, integrity, and compliance of billing processes under the CalAIM programs. This role involves reviewing billing discrepancies, identifying recurring patterns, resolving issues to prevent future occurrences, and recommending system and process improvements to enhance operational efficiency and maintain regulatory compliance.
Salary: $80k-$100k
Schedule: M-F 8am-5pm
Direct Hire Opportunity
Key Responsibilities:
-
Billing Error Review and Resolution:
- Perform thorough evaluations of billing errors and discrepancies within the CalAIM programs.
- Work closely with billing teams and other departments to identify the root causes of issues and implement timely resolutions.
- Ensure resolved errors are documented and shared for future reference to prevent recurrence.
-
Identification of Billing Patterns:
- Investigate recurring billing issues to uncover underlying trends and systemic challenges.
- Analyze common patterns that contribute to errors and inefficiencies, and recommend corrective actions to address them.
- Maintain detailed records and generate reports on identified trends for management review and further action.
-
System and Process Improvement:
- Collaborate with compliance and IT teams to propose system upgrades and improvements that address billing inefficiencies.
- Recommend workflow enhancements aimed at reducing error rates and improving billing processes.
- Stay current on updates to CalAIM billing regulations and suggest necessary adjustments to ensure compliance.
-
Training and Staff Support:
- Provide feedback and training to billing staff on common error patterns and error prevention techniques.
- Create and distribute helpful resources such as guides, checklists, and materials to promote consistent billing accuracy.
-
Compliance and Reporting:
- Ensure that all billing activities comply with CalAIM regulations and internal policies.
- Prepare detailed reports that highlight error trends, resolutions, and recommendations for process improvements.
- Support audit preparations by ensuring billing accuracy and adherence to regulatory standards.
Qualifications:
- Bachelor’s degree in finance, business administration, healthcare administration, or a related field (or equivalent experience).
- Proven experience in medical billing, quality assurance, or compliance, with preference for experience within Medi-Cal or CalAIM frameworks.
- Strong analytical skills with the ability to identify trends, root causes, and patterns in billing data.
- Proficiency in billing software, data analysis tools, and reporting systems.
- Excellent written and verbal communication skills.
- Detail-oriented with a proactive approach to problem-solving.
- Knowledge of Medi-Cal regulations and CalAIM initiatives is highly desirable.
Preferred Skills:
- Experience with process improvement methodologies such as Six Sigma or Lean.
- Strong organizational, time-management, and multi-tasking abilities.
- Ability to collaborate effectively across various departments and teams
- 100% healthcare
- Two or Three weeks vacationÂ
- 13 holidaysÂ
- 401(k) match up to 3%
- #Indhp
Additional Information
Career Expert
Monica Prudhume
Staffing Account Manager
Meet Monica, our Staffing Account Manager on the Central CA team! With a background in the dental field spanning over 16 years, she transitioned into the field of recruitment around 2 years ago. Her extensive experience in the dental field has equipped her with a deep understanding of people's needs and a passion for helping others. Monica's goal here at Hire Up Staffing is to excel in her profession and make a positive impact on the lives of job seekers and employers alike. Known for her exceptional customer service skills, she consistently goes above and beyond to ensure that every individual she interacts with receives the utmost care and attention. Monica loves being a part of the Hire Up team, as the company's culture aligns perfectly with her values and aspirations. She is eager to expand her knowledge base and leverage her skill sets in a supportive environment that fosters growth and development. When Monica is not busy pursuing her professional goals, she enjoys spending quality time with her family. Monica's commitment to both her personal and professional life reflects her dedication, adaptability, and strong work ethic.