Office Assistant Specialist-Billing - Department Promotional
San Joaquin General Hospital
|Approximate Salary||$3,141 - $3,815/Month|
|Opening Date||7/9/2018 08:00:00 AM|
|Closing Date||7/20/2018 11:59:00 PM|
|Tentative Exam Date||July 27, 2018|
This examination is being given to fill several full-time positions in the San Joaquin General Hospital's Patient Accounting Department and to establish a list to fill future vacancies.
The Office Assistant Specialist (Biller) assigned to the Patient Accounting Department will be responsible for hospital institutional, outpatient billing, and reimbursement. The incumbent will be responsible for submitting claims for reimbursement of patient charges to various parties, including Medi-Cal, Medicare, and insurance companies. The ideal candidate will have knowledge of basic medical terminology, electronic medical billing practices, procedures and codes, institutional billing and hospital physician and outpatient procedures and services required.
San Joaquin General Hospital is a public hospital and a designated level III Trauma Center. The hospital, originally established in 1857, is a 196-bed general acute care facility providing a full range of both inpatient and outpatient services. SJGH's friendly staff works hard to provide the highest quality care services to the residents of San Joaquin County.
To learn more about the department, visit: www.sjgeneral.org
Resumes will not be accepted in lieu of an application.
NOTE: All correspondences relating to this recruitment will be delivered via e-mail. The e-mail account used will be the one provided on your employment application during time of submittal. Please be sure to check your e-mail often for updates. If you do not have an e-mail account on file, Human Resources will send you correspondences via US Mail.
· Reviews accounts for accurate billing information including required patient and payer specific documentation and charges. Determines when accounts are billable. Ascertains that the proper authorizations were obtained per various payer and utilization review guidelines and that the length of stay matches approved and denied days.
· Reviews claims by accessing the most current version of the UB and CMS 1500 editors.
· Processes claims either electronically to Medicare, Medi-Cal, Managed Care, Commercial payers or queue to print accurately to intermediaries and/or third parties according to applicable rules and regulations based on payer and Business Office protocols.
· Generates claims for such special circumstances as "stop less," interim or cycle bills or other payer driven provisions.
· Processes late charges after determining the impact on reimbursement.
· Bills "stop less" accounts and individual contract accounts according to department policy as well as insurance/government contract provisions.
· Provides timely and effective follow-up and resolution on unpaid, underpaid and overpaid government, third party, and patient balances through the use of the Aged Trial Balance reports, tickler files, and directives from Supervisor or Manager.
· Performs various patient account maintenance functions, such as refunds, adjustments, transfers between accounts, address changes, etc.
· Analyzes the transaction to identify and process corrections for errors or omissions made in the processing of payment and adjustments.
· Analyses and determines who should receive the refund(s) and the amount(s) and prepares a refund request for supervisory approval and submission Accounts Payable for processing.
· Serves as a resource to patients, payers, peers and other departments in the processing and resolution of billing related functions and tasks.
· Performs other related work as required/assigned.
PLEASE NOTE: This is a departmental promotion. Qualified applicants must currently be employed with San Joaquin General Hospital and meet the promotional eligibility requirements as stated in Civil Service Rule 10, Section 3-Eligiblity for Promotional Examinations.
Note: Supplemental application must be submitted with employment application.
Note: The following special requirements were approved by the Civil Service Commission on October 3, 2017.
Experience: One year of work at a level equal to or higher than Senior Office Assistant in San Joaquin County service which included electronic billing and follow-up in a medical or healthcare setting.
Experience: Three years of experience performing medical billing, including at least two years of functioning at a full-journey level performing Medi-Cal and/or Medicare electronic billing for a hospital or a high volume professional practice.
Billing and collection rules and regulations including Medicare, Medi-Cal, insurance companies; knowledge of basic arithmetic; bookkeeping and account reconciliation procedures and techniques, general hospital operations and business practices, correspondence and documentation procedures; knowledge of computer-based patient accounting management systems; knowledge of medical terminology and familiarity with current diagnostic and procedure coding.
Research, interpret and apply complex laws/regulations; third-party reimbursement rules/requirements related to hospital patient accounting practices and procedures; evaluate and establish priorities; gather, organize, input and maintain complex information; follow complex oral and written procedures and directions; establish and maintain effective working relationships with others; communicate effectively with others; write clearly and legibly; perform advanced arithmetical operations; may train, lead or supervisor others.
Mobility-Frequent operation of a data entry device, repetitive motion, sitting for long periods, walking; occasional standing, pushing, pulling, bending, squatting, climbing; Lifting-Frequently 5 pounds or less; occasionally 5 to 30 pounds; Visual-Constant good overall vision and reading/close-up work; frequent color perception and use of eye/hand coordination; occasional use of depth perception and peripheral vision; Hearing/Talking-Frequent hearing of normal speech, hearing/talking on the telephone, talking in person; Emotional/Psychological-Frequent decision making, concentration, and public contact; Special Requirements-Some assignments may require working weekends, nights, and/or occasional overtime; Environmental-Occasional exposure to varied weather conditions.
Employees hired into this classification are members of a bargaining unit which is represented by SEIU Local 1021.
Health Insurance: San Joaquin County provides employees with a choice of three health plans: a Kaiser Plan, a Select Plan, and a Premier Plan. Employees pay a portion of the cost of the premium. Dependent coverage is also available.
Dental Insurance: The County provides employees with a choice of two dental plans: Delta Dental and United Health Care-Select Managed Care Direct Compensation Plan. There is no cost for employee only coverage in either plan; dependent coverage is available at the employee’s expense.
Vision Insurance: The County provides vision coverage through Vision Service Plan (VSP). There is no cost for employee only coverage; dependent coverage is available at the employee’s expense.
For more detailed information on the County’s benefits program, visit our website at www.sjgov.org under Human Resources/Employee Benefits.
Life Insurance: The County provides eligible employees with life insurance coverage as follows:
1 but less than 3 years of continuous service: $1,000
3 but less than 5 years of continuous service: $3,000
5 but less than 10 years of continuous service: $5,000
10 years of continuous service or more: $10,000
Employee may purchase additional term life insurance at the group rate.
125 Flexible Benefits Plan: This is a voluntary program that allows employees to use pre-tax dollars to pay for health-related expenses that are not paid by a medical, dental or vision plan (Health Flexible Spending Account $2550 annual limit with a $500 carry over); and dependent care costs (Dependent Care Assistance Plan $5000 annual limit).
Retirement Plan: Employees of the County are covered by the County Retirement Law of 1937. Please visit the San Joaquin County Employees’ Retirement Association (SJCERA) at www.sjcera.org for more information. NOTE: If you are receiving a retirement allowance from another California county covered by the County Employees’ Retirement Act of 1937 or from any governmental agency covered by the California Public Employees’ Retirement System (PERS), you are advised to contact the Retirement Officer of the Retirement Plan from which you retired to determine what effect employment in San Joaquin County would have on your retirement allowance.
Deferred Compensation: The County maintains a deferred compensation plan under Section 457 of the IRS code. You may annually contribute $18,000 or 100% of your includible compensation, whichever is less. Individuals age 50 or older may contribute to their plan, up to $24,000. The Roth IRA (after tax) is also now available.
Vacation: Maximum earned vacation is 10 days each year up to 3 years; 15 days after 3 years; 20 days after 10 years; and 23 days after 20 years.
Holidays: Effective July 1, 2017, all civil service status employees earn 14 paid holidays each year. Please see the appopriate MOU for details regarding holidays, accruals, use, and cashability of accrued time.
Sick Leave: 12 working days of sick leave annually with unlimited accumulation. Sick leave incentive: An employee is eligible to receive eight hours administrative leave if the leave balance equals at least one- half of the cumulative amount that the employee is eligible to accrue. The employee must also be on payroll during the entire calendar year.
Bereavement Leave: 3 days of paid leave for the death of an immediate family member, 2 additional days of accrued leave for death of employee’s spouse, domestic partner, parent or child.
Merit Salary Increase: New employees will receive the starting salary, which is the first step of the salary range. After employees serve 52 weeks (2080 hours) on each step of the range, they are eligible for a merit increase to the next step.
Job Sharing: Employees may agree to job-share a position, subject to approval by a Department Head and the Director of Human Resources.
Educational Reimbursement Program: Eligible employees may be reimbursed for career-related course work up to a maximum of $850 per fiscal year. Eligible employees enrolled in an approved four (4) year College or University academic program may be reimbursed up to $800 per semester for a maximum of $1600 per fiscal year.
Parking Supplemental Downtown Stockton: The County contributes up to $17 per pay period for employees who pay for parking and are assigned to work in the Downtown Core Area.
School Activities: Employees may take up to 40 hours per year, but not more than eight (8) hours per month, to participate in their children’s school activities.
Civil Service Rule 10 – Section 3 – Eligibility for Promotional Examinations
To compete in a promotional examination, an employee must:
A. Meet the minimum qualifications of the class on or before the final filing date for filing applications.
B. Meet one of the following qualifying service requirements:
1. Have permanent status in the Classified Service.
2. If a probationary employee in Classified Service, must have served twelve (12) continuous and consecutive months immediately prior to the final filing date. Qualifying service under this rule may have been in either the Classified service or in any combination of Classified Service and service under a public employment program.
3. Public employment program employees who have served at least twelve (12) continuous and consecutive months immediately prior to the final filing date are eligible to compete in promotional examinations for entry level classes or a class equivalent to their current public employment class. For the purpose if this rule, an entry level class is defined as the lowest class in each class series excluding classes designated as trainee classes in the class title.
4. Employees in the Classified Service who have six (6) continuous months’ service in trainee classes or entry level classes, as defined above, shall be eligible for promotional examinations to the next higher class in that same series.
5. Temporary, contract, or exempt employees who have at least six (6) months of full-time service with the County within the last twenty-four (24) months and are currently employed with the County immediately prior to the final filing date are eligible to compete in promotional exams for entry level or trainee classes.
6. Contract or exempt incumbents of positions which are converted to classified service are eligible to compete in promotional exams for the classes of positions which they occupy if they have served 2080 continuous and consecutive payroll hours (equivalent to one (1) year) in the same or related classes of positions as the promotional class immediately prior to the final filing date.
7. A Part-time employee who is actively employed (on payroll) and who has worked 2080 continuous and consecutive hours in a class that is above entry level may compete in promotional recruitment for that classification.
C. Have a rating of satisfactory or better on the last performance evaluation, if applicable.
D. If a person whose name is on a promotional list is separated (except for layoff) the name shall be removed from the promotional list of the action.
Employees who meet the minimum qualifications will go through one of the following examination process:
- Written Exam: The civil service written exam is a multiple choice format. If the written exam is administered alone, it will be 100% of the overall score. Candidates must achieve a minimum rating of 70% in order to be placed on the eligible list.
- Oral Exam: The oral exam is a structured interview process that will assess the candidate’s education, training, and experience and may include a practical exercise. The oral exam selection process is not a hiring interview. A panel of up to four people will determine the candidate’s score and rank for placement on the eligible list. Top candidates from the eligible list are referred for hiring interviews. If the oral exam is administered alone, it will be 100% of the overall score. Candidates must achieve a minimum rating of 70% in order to be placed on the eligible list.
- Written & Oral Exam: If both a written exam and an oral exam is administered, the written exam is weighted at 60% and the oral exam is weighted at 40% unless otherwise indicated on the announcement. Candidates must achieve a minimum rating of 70% on each examination in order to be placed on the eligible list.
- Rate-out: A rate-out is an examination that involves a paper rating of the candidate’s application using the following criteria: education, training, and experience. Candidates will not be scheduled for the rate-out process.
Note: The rating of 70 referred to may be the same or other than an arithmetic 70% of the total possible points.
Testing Accommodation: Candidates who require testing accommodation under the Americans with Disabilities Act (ADA) must call Human Resources Division at (209) 468-3370 prior to the examination date.
Eligible Lists: Candidates who pass the examination will be placed on an eligible list for that classification. Eligible lists are effective for one year, but may be extended up to two additional years by the Civil Service Commission.
Certification/Referral: Names from the eligible list will be referred to the hiring department by the following methods.
- Rule of Five: The top five names will be referred for hiring interviews. This applies only to department or countywide promotional examination.
Physical Exam: Some classifications require physical examinations. Final appointment cannot be made until the eligible has passed the physical examination. The County pays for physical examinations administered in its medical facilities.
Employment of Relatives: Applicants who are relatives of employees in a department within the 3rd degree of relationship, (parent, child, grand parent, grand child or sibling) either by blood or marriage, may not be appointed, promoted, transferred into or within the department when;
· They are related to the Appointing Authority or
· The employment would result in one of them supervising the work of the other.
Department Head may establish additional limitations on the hiring of relatives by departmental rule.
HOW TO APPLY
By mail or in person:
San Joaquin County Human Resources
44 N. San Joaquin Street Suite 330
Stockton, Ca 95202
Monday – Friday 8:00 am to 5:00 pm; excluding holidays.
Phone: (209) 468-3370
For current employment opportunities please call our 24-hour job line at (209) 468-3377.
When a final filing date is indicated, applications must be filed with the Human Resources Division before 5:00 p.m. or postmarked by the final filing date. Resumes will not be accepted in lieu of an application. Applications sent through county inter-office mail, which are not received by the final filing date, will not be accepted. (The County assumes no responsibility for mailed applications which are not received by the Human Resources Division).
San Joaquin County Substance Abuse Policy: San Joaquin County has adopted a Substance Abuse Policy in compliance with the Federal Drug Free Workplace Act of 1988. This policy is enforced by all San Joaquin County Departments and applies to all San Joaquin County employees.
Equal Opportunity Employer: San Joaquin County is an Equal Employment Opportunity (EEO) Employer and is committed to providing equal employment to all without regard to age, ancestry, color, creed, marital status, medical condition, national origin, physical or mental disability, political affiliation or belief, pregnancy, race, religion, sex, or sexual orientation. For more information go to www.sjgov.org/department/hr/eeo.