Billing Authorization Specialist

Job Title: Billing Authorization Specialist
Location: Remote
Job-Type: Full-time
Hours: 8:00am to 5:00pm (Pacific Time, GMT -8:00)

Consider yourself a Medical Billing Whiz Kid? Are you adept at transforming complex billing processes into smooth, efficient operations? Rooted Life is on the lookout for a Billing Authorization Specialist like you! Join us and become an integral part of a team that navigates the intricate world of healthcare billing and authorization with precision and care. In this role, you’ll be the linchpin in our financial workflow, turning billing challenges into triumphs with your expertise and dedication.

First, Who Is Rooted Life?
Rooted Life offers essential services in California, aiding those experiencing homelessness, recovering from hospital and/or other institutional stays, or anyone facing housing challenges. Our approach includes guiding individuals in finding and securing safe, stable homes, providing financial assistance for initial housing costs, and offering ongoing support to maintain stable living situations. The organization also provides temporary residential care for those with medical or behavioral health needs but without stable housing. Employing a scattered site housing model, Rooted Life ensures each residence is fully furnished, creating environments conducive to healing and recovery.

Rooted Life focuses on progression, foundation and connection. We do our very best to meet people where they are, and encourage them to develop their skills and abilities, so they may live the best life possible. By providing individualized attention and compassion as an essential aspect of our home, we can better assist those living with psychiatric vulnerabilities and addictions. Our teams provide an environment where men and women can move from surviving to living.

Who We’re Looking For:
Are you ready to be more than just a cog in the machine? At Rooted Life, we’re seeking dynamic individuals who are not just task performers but true leaders in their roles. We want someone who brings more to the table than just skills — a visionary who’s ready to innovate and inspire.

???? Detail-Oriented Administrator: Excelling in providing top-notch administrative support for seamless office operations.
???? Authorization Expert: Skilled in handling authorization processes, from client authorization to tracking and managing denied cases.
???? Documentation Dynamo: Collaborating with care managers and staff to secure all essential documentation for billing and authorization.
???? Invoicing Pro: Proficient in submitting accurate invoices for Enhanced Care Manager (ECM) or Community Supports services, adhering to CalAIM standards and Managed Care Plan (MCP) requirements.
???? Collaborative Communicator: Working across departments to gather and analyze client information, ensuring effective billing records.
???? Reimbursement Maximiser: Focused on ensuring maximum reimbursement through meticulous billing and coding for all services rendered.
???? Claims Specialist: Managing the full claims process, from creation to follow-up, and handling insurance inquiries with expertise.
????? HIPAA Guardian: Upholding the strictest confidentiality and adhering to all HIPAA regulations.

What You’ll Be Doing
Note this is not a standard medical billing job – there are only about 11 codes to get up to speed on. We are looking for someone who is truly a workflow and process expert to help build an efficient billing process and put it in action.

???? Administrative Support: Provides administrative support to ensure efficient operation of the office.
???? Authorization Processes: Handles all authorization processes including authorizing clients and tracking authorizations until acceptance, working with MCPs for any denied clients.
???? Documentation Collection: Works with LCMs and CS Staff to obtain all documentation required for billing and authorization purposes.
???? Claims Submission: Submit claims for the provision of ECM-related services to MCPs using the national standard specifications and code sets to be defined by DHCS.
???? Invoice Management: Submitting and managing invoices in line with CalAIM ECM and CS Provider Standards.
???? Reimbursement Maximization: Ensures that maximum reimbursement is obtained through billing and coding, or all services rendered.
????? Claims Processing: Responsible for correcting, completing, and processing claims of all-payer codes.
???? Queue Monitoring: Daily monitoring of assigned queues for claim progression directly impacting timely payments.
????? Claims Management: Manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, and insurance inquiries/correspondence.
?? Clean Claims Submission: Prepares and submits clean claims to third-party payers either electronically or by paper per the payor guidelines.
???? Confidentiality Maintenance: Maintains the strictest confidentiality; adheres to all HIPAA guidelines/regulations.
???? Monthly Reporting: Submit monthly reports of activities and developments to company leadership.
???? Revenue Cycle Contribution: Contributes to every stage of the revenue cycle, from claim submission to denial management to payment posting review and reporting.

Qualifications
?? Superb Skills: Excellent in administrative writing, data analysis, and process management.
???? Tech-Savvy: Proficient with MS Office, Google Docs, and Google Drive, with a knack for quickly mastering new software.
???? Analytical Mindset: Outstanding at evaluating performance metrics and solving complex problems.
????? Communication Maestro: Exceptional in both written and verbal communication.
???? Educational Background: University degree and; 5 or more years of US medical billing experience or an equivalent combination of education and experience.
???? First-Rate Reasoning Ability: Capable of applying common sense to carry out instructions and solve problems with multiple variables.

Pay:
$10/hour

Our Values:
At Rooted Life, we believe in compassion, respect, and empowerment. Our environment is not just supportive and inclusive, but it’s also a space where we are dedicated to nurturing stable and healing living environments for those in need. To fortify our mission, we adhere to a set of core values that guide our actions and decisions:
Integrity. Do what you say and say what you do. We speak honestly and act ethically – be straightforward. Our character guides our daily work and we gain the confidence of others by doing the right thing. We build a supportive workplace that is centered on trust.
? Excellence. Great just isn’t good enough, we are passionate about setting and achieving ambitious goals and strive to deliver the highest quality and value possible through simple, easy and relevant solutions .
? Accountability. If it is to be, it’s up to me – like Nike said, just do it.
? Curiosity. We foster a culture of inquisitiveness and continuous learning. Curiosity drives us to explore new ideas, seek out innovative solutions, and remain open-minded in every aspect of our work. It’s through asking questions and being eager to learn that we uncover new ways to support our clients and advance our mission.
? Solutions Oriented Mindset. We believe every obstacle has a solvable solution. We embrace that our work is hard, and sometimes does not go as planned. We meet these challenges head on and constantly strive to look for solutions to better ourselves and our products and services.
? Second Order Thinking. We’re not just about making quick decisions; we’re about making smart ones. Our ideal candidate is someone who thinks two steps ahead, understanding the ripple effects of their actions. In this role, you’ll be expected to not just react to data, but to anticipate the future implications of today’s campaigns. It’s all about strategic foresight – seeing the bigger picture and understanding how each move can impact our clients’ success down the line. We want someone who asks, “If we do this, what happens next?” and then plans accordingly. Be the chess player, not the chess piece!
? Resource Efficiency. We believe that solicitation and prudent utilization of resources is essential to the long term health and wealth of the company. Keep an eye on expenses and make smart, sustainable choices even in the small, everyday things.
? Collaborative. Communicating and working with others for the benefit of all. Our great colleagues make the difference. It’s when we share our skills, knowledge and experience we become one team. Diversity makes us strong.