About Cardea Health:
Cardea Health is a non-profit organization dedicated to providing compassionate health care to marginalized populations. Our mission is to create and support programs that protect the health and autonomy of vulnerable individuals and promote equity and social justice to improve the well-being of our entire community. We provide medical support to populations that experience homelessness.
At Cardea, we are dedicated to creating a workplace that celebrates diversity and actively seeks to include underrepresented communities. We believe that diversity drives innovation and fosters a more dynamic, inclusive, and productive work environment. We actively encourage individuals from underrepresented backgrounds to apply for our open positions. We value your unique perspectives, experiences, and talents, and we are committed to providing equitable opportunities for growth and advancement. Join us in building a team that reflects the rich diversity of our society and let's make a positive impact together.
Primary Work Location:
Remote, supporting all our physical clinical supportive housing sites
Job Summary:
Cardea Health's Medical Biller will work closely with the CEO, president, and clinical team to bill for medical services. The medical biller will establish and maintain a tracking and submission system for medical claims. In addition, the medical biller will occasionally perform routine clerical and administrative functions such as drafting correspondence, organizing and maintaining paper and electronic files.
Job Duties & Responsibilities:
Submit treatment authorization requests (TARs) to Medi-Cal
Submit Medi-Cal claims, including claims for CalAIM covered services
Follow up on the status of TARs and claims submitted
Track eligibility for Medi-Cal and program services
Submit authorizations and claims to managed Medi-Cal plans
Submit billing data to the appropriate insurance providers
Process claims
Resolve denial instances
Appeal denied authorizations and claims
Achieve maximum reimbursement for services provided
Establish and maintain tracking systems for billing submission
Conduct audits and Medi-Cal reviews
Assist with organizational readiness for contracting with larger partners (Alameda County, Alameda Alliance and Kaiser). This will include providing support for financial audits, compliance submissions, and billing reports
Other duties as assigned
Minimum Required Skills & Qualifications:
Medical biller experience: Minimum 1 year experience
Comprehensive knowledge of medical terms and codes used in healthcare billing
Ability to communicate in a clear and professional manner with patients, healthcare providers, and insurance companies regarding billing inquiries and outstanding balances
Strong attention to detail with excellent organizational skills
Strong critical thinking abilities
Ability to manage multiple tasks efficiently and maintain organized records
Proficiency with billing using Excel.
Proficiency using Microsoft office: Word, Excel, Teams
Familiarity with electronic health records (EHR) and medical billing software to submit claims electronically or manually if needed.
Self-directed and able to work with minimal supervision
Preferred Skills & Qualifications:
Medical biller experience: 2 years preferred
Experience working with the homeless population
College degree or specific certification related to position
Physical Requirements:
Work Environment:
Cardea Health is an Equal Opportunity Employer
Cardea Health is committed to diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, age, gender identity or gender expression, genetic information, marital status, national origin, disability, citizenship or veteran status. We will consider qualified candidates with criminal histories in a manner consistent with the requirements of the state of California and San Francisco Fair Chance Ordinance.
This job description is not designed to contain a comprehensive list of activities, duties, or responsibilities for this role. Activities, duties, or responsibilities may change, or a new job description may be assigned at any time with or without notice.
