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Recruitment #19-CH4-01



THE JOB: Under direction, responsible for the recovery of costs for medical care through the billing of patients, insurers, third party payers, or various medical aid programs; and performs other work as required.

Employment Standards

THE REQUIREMENTS: Any combination of training and experience, which would provide the required knowledge and abilities, is qualifying. A typical way to obtain the knowledge and abilities would be:

The equivalent of one year of full-time experience in the class of Senior Account Clerk or in an equivalent or higher clerical class performing medical billing or medical accounting in a County Health Services Agency or other similar environment;


The equivalent of two years’ full-time experience performing medical billing or medical accounts receivable functions.


Possession of one (1) of the following valid certifications (current): Certified Coding Specialist (all types) or Registered Health Information Administrator or Registered Health Information Technician or Certified Professional Coder (all types), or one year of similar experience in a medical setting outside of the County's medical services, or completion of an accredited medical billing and coding program at a college or institution of higher education.

Special Requirements: Successful completion of a fingerprint background check.

Knowledge: Thorough knowledge of medical billing procedures, operations and diagnostic and procedural coding; sources and eligibility requirements for publicly funded medical care payment programs such as Medicare, Medi-Cal, Short-Doyle Medi-Cal, Healthy Families and other private insurance; medical terminology and insurance claim procedures common to medical billing and accounts receivable operations; retroactive billing process for Medi-Cal and other payors where eligibility is established after service delivery. Working knowledge of purposes, methods and practices of billing, accounts receivable, and collection; basic medical terminology and spelling; current Procedural Terminology and other reference and resource materials related to patient account activities; managed care and fee-for-service payment methods; fiscal transactions, information, procedures and other related activities with intra- and inter-departmental units, other agencies; a variety of fiscal records, ledgers, journals, computer data and other documents; maintenance of such records include the accurate posting, recording, balancing, adjusting and reconciling of figures, date or transactions; compilation, organization and preparation of a variety of complex reports dealing with fiscal transactions; collection and deposit of funds; modern office administrative practices and procedures, including business correspondence and computer skills; filing, office equipment operations and on-line computers; business arithmetic; principles and practices of customer service and telephone courtesy; purpose and use of International Classification of Disease Standards (ICD) and Diagnostic & Statistical Manual of Mental Disorders (DSM); purpose and use of the Concurrent Procedure Terminology (CPT); legal requirements of State, Federal and County Policies and Procedures related to billing and collection activity and the release of confidential patient information, including HIPAA requirements.

Ability to: Prepare financial reports and maintain ledgers and journals using computer software; operate a patient accounts computer system; interpret program billing policies, procedures, and billing regulations; work independently with minimal direct supervision; plan and organize work; prepare accurate arithmetical computations; understand and follow oral and written directions; read and interpret procedure manuals; input accurate data into various computer systems in a timely manner; maintain patient confidentiality; operate 10-key adding machine; efficiently operate a keyboard; adjust to changes in workflow and meeting deadline; communicate effectively orally and in writing; establish and maintain effective working relationships with all levels of medical, professional, administrative and support personnel contacted in the course of work; in some assignments research, explicate, and prepare spread sheets on complex billing, accounts receivable, and insurance coverage records; evaluate patient financial status and payer sources; establish payment plans, and follow-up and collect past due accounts; evaluate, determine and approve eligibility for specialized publicly funded medical care payment programs; perform detailed clerical work in a methodical and thorough manner with speed and accuracy; spell correctly and use correct business English; provide courteous customer service to patients; write neatly and legibly; supervise the work of subordinate clerical employees may be required of certain positions; physically and mentally be capable of performing the position’s essential functions as summarized in the typical tasks section of this specification.


ANNUAL LEAVE - 22 days first year, increasing to 37 days after 15 years of service. Available for vacation and/or sick leave.
HOLIDAYS - 13 paid holidays per year.
BEREAVEMENT LEAVE - 3 days paid in California, 5 days paid out-of-state.
MEDICAL PLAN - The County contracts with CalPERS for a variety of medical plans. For most plans, County contributions pay a majority of the premiums for employees and eligible dependents.
DENTAL PLAN - County pays for employee and eligible dependent coverage.
VISION PLAN - County pays for employee coverage. Employee may purchase eligible dependent coverage.
RETIREMENT - Pension formula 2% at age 60 or 2% at age 62 as determined based on provisions of the CA Public Employees’ Pension Reform Act of 2013(PEPRA). Pension benefit determined by final average compensation of three years. County participates in Social Security.
LIFE INSURANCE - County paid $20,000 term policy. Employee may purchase additional life insurance.
DISABILITY INSURANCE - Employees in the General Representation Unit participate in the State Disability Insurance (SDI) program. This program is funded 100% by employee payroll deductions.
DEPENDENT-CARE PLAN - Employees who make contributions for child or dependent care may elect to have their contributions made utilizing “pre-tax dollars.”
H-CARE PLAN - Employees who pay a County medical premium may elect this pre-tax program.
HEALTH CARE FLEXIBLE SPENDING ALLOWANCE (HCFSA) - Employees may elect this pre-tax program to cover qualifying health care expenses.
DEFERRED COMPENSATION - A deferred compensation plan is available to employees

Selection Plan

THE EXAMINATION: Your application will be reviewed to determine if you have met the education, experience, training and/or licensing requirements as stated on the job announcement. If you meet these criteria and are one of the best qualified, you may be required to compete in any combination of written, oral and/or performance examinations or a competitive evaluation of training and experience as described on your application. You must pass all components of the examination to be placed on the eligible list. The examination may be eliminated if there are ten or fewer qualified applicants. If the eligible list is established without the administration of the announced examination, the life of the eligible list will be six months and your overall score will be based upon an evaluation of your application. If during those six months it is necessary to administer another examination for this job class, you will be invited to take the examination to remain on the eligible list.

HOW TO APPLY: Apply Online Now!  Click on the link below; or print out an application and mail/bring application to: Santa Cruz County Personnel Department, 701 Ocean Street, Room 510, Santa Cruz, CA, 95060.  For information, call (831) 454-2600.  Hearing Impaired TDD/TTY: 711.  Applications will meet the final filing date if received in one of the following ways:  1) in the Personnel Department by 5:00 p.m. on the final filing date, 2) submitted online before midnight of the final filing date.

Women, minorities and people with disabilities are encouraged to apply.  If you have a disability that requires test accommodation, please call (831) 454-2600.  

To comply with the 1986 Immigration Reform and Control Act, Santa Cruz County verifies that all new employees are either U.S. citizens or persons authorized to work in the U.S.

NOTE: The provisions of this bulletin do not constitute an expressed or implied contract.

An Equal Opportunity Employer

County of Santa Cruz



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