“Every person deserves compassion, dignity, and the safety of a place to call home.”

Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care centers, emergency shelters, housing services and children's and family programs. IF currently has 13+ facilities with 22+ micro-communities scattered across Orange County, Los Angeles County and the Inland Empire.

Job Description

The Claims Specialist is responsible for accuracy of claims submission, benefits and eligibility verification, accuracy of client information. In addition, the Claims Specialist is also responsible for keeping up to date accounts receivable for both CalAIM and IFMG, claim follow-up, and must have knowledge of billing codes.

The pay range for this position is $25.00 - $27.00 per hour, depending on experience. After successful completion of 90-day probation period, this position will be eligible for Hybrid schedule with 2days in office and 3days working from home.

Responsibilities

CalAIM Billing and Follow up

Reviewing data and creating Claims for services rendered
Review client records to extract applicable data necessary for billing purposes, including but limited to ICD 10 Diagnosis codes, CPT codes for services rendered etc
Review any rejected or denied claims and conduct proper follow up procedures
Ensure claims meet the standards of our contracts and programs
Verify eligibility of each client prior to creating and submitting claims
Have knowledge in understanding, reading EOB’s and Remittance Advice
Posting payment accurately to claims and continuing with the claim close out process
Assist Manager and Associate Director in any projects related to billing that may come up

IFMG Billing and Follow up

Reviewing encounters for PCP, Psychiatry, and behavioral health, ensuring CPT codes, and ICD 10 codes used by Dr are applicable to the service rendered before submitting encounter as a claim
Familiar with Athena or similar EHR system
Verifying client's insurance falls into one our contracted insurance prior to billing
Following up on claims that were denied, rejected, or held in the EHR system which includes appeals, corrections, resubmissions

Preferred Experience/Minimum Qualifications

Required:

High School Diploma or equivalent
1-2 years' relevant experience
Basic computer skills, including the ability to send and receive emails and summarize data in spreadsheets
Valid CA Driver’s License and eligibility for company vehicle insurance
Prior experience work in Electronic Billing Platforms and EHR systems
Prior experience working with claims and communication with health networks

Preferred:

Proficiency in Microsoft (Outlook, Word, Excel, Teams)
Associate’s Degree
Bachelor's degree
Experience in Medical Billing and Primary Care Billing
Medical Billing Certification

Benefits

Hybrid schedule with 2days in office and 3days working from home (After successful completion of 90-day probation period)
Medical Insurance funded up to 91% by Illumination Foundation (Kaiser and Blue Shield), depending on the plan
Dental and Vision Insurance
Life, AD&D and LTD Insurance funded 100% by Illumination Foundation
Employee Assistance Program
Professional Development Reimbursement
401K with Company Matching
10days vacation PTO/year
6 days sick PTO/year
10 days holiday PTO/year
Potential eligibility for the Public Service Loan Forgiveness Program (PSFL) for federally qualified loans

Illumination Foundation

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Claims Specialist