Billing Compliance Specialist

Posted 3 Days Ago
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San Dimas, CA, USA
In-Office
20-22 Hourly
Entry level
Kids + Family • Social Impact
The Role
Reviews client documentation, billing records, and claims for regulatory and agency compliance. Tracks and reconciles county billing, corrects denied claims, prepares invoices, monitors authorizations and payment reports, and maintains reconciliation reports. Conducts chart audits, identifies documentation deficiencies, supports staff corrections, prepares records for regulatory audits, and participates in performance and quality improvement activities.
Summary Generated by Built In

McKinley: Youth, Family, and Community are what we are all about! We offer a great working environment and benefits package! McKinley encourages growth so that you can Be your Best H.U.M.A.N.

At McKinley employees share a set of guiding principles: We embrace a culture that is Hopeful, Understanding, Moral, Awesome, Nurturing. - H.U.M.A.N.

The Company: McKinley is a highly respected welfare organization with a comprehensive array of programs and services – which touch nearly 1,800 lives annually – including short term residential treatment program (STRTP), Foster Care, Adoptions, Mental Health Services, and Special Education. McKinley has 5 locations throughout southern California with our main campus located in San Dimas. We embrace a culture that is H.U.M.A.N.- Hopeful, Understanding, Moral, Awesome, Nurturing. McKinley has created a Hopeful environment, in which we choose optimism in finding the motivation to achieve our greatest dreams. We are a team dedicated to Understanding individual needs and do so by listening and embracing each individual’s stories. We strongly embrace our agency’s Morals by treating everyone with kindness and respect. At McKinley, we acknowledge our team member’s and clients’ Awesome qualities by celebrating what makes each individual unique. We are dedicated to Nurturing a Trauma-Informed Integrated Care approach that has created a unique culture within the organization. We celebrate diversity by our commitment to cultivating an inclusive and affirming environment for all.

The Position: The Billing Specialist is responsible for the review and content compliance of any and all documentation submitted to the client record. This is to include day to day department functions, tracking of billing and claim reconciliation and work in tandem with outside agencies to maintain current procedures, involvement in audits performed by regulatory agencies, conduct quality assurance activities and periodic record reviews of all active and discharged clients.

Compensation and Benefits:

The pay range we’re offering is $20.00- $22.00 hourly, depending (Based) on experience.

Our people are the heart of our organization, which is why we offer robust benefits to support your health and wellness as well as your personal and financial well-being.

  • Medical, Dental, and Vision Insurance
  • Life Insurance
  • Flexible Spending Account
  • Paid Time Off
  • Sick Time
  • Paid Holidays
  • 403(b) retirement plan with company match up to 3%
  • Employee Assistance Program
  • Tuition Reimbursement
  • Employee Rewards Program
  • Credit Union Membership
  • Training Opportunities to Further Personal and Professional Growth

Qualifications:

  • Bachelor’s Degree in Social Work, Psychology, Public Administration or in any other related discipline preferred
  • Prior Quality Assurance Experience including knowledge of IBHIS and billing codes requirements or Case Management Experience Strongly Preferred
  • Word Processing, e-mail, internet, ability to learn clinical software, basic office skills (i.e. typing, telephone, copier)
  • Microsoft Excel, Power Bi and Adobe Acrobat
  • Must pass pre-employment physical exam, TB and drug screening
  • Ability to commute to various sites on and off campus
  • Ability to work extended hours as needed
  • Ability to physically restrain children (if needed)
  • DOJ, FBI, Child Abuse Index
  • Insurability Under Corporate Automobile Insurance

Key Responsibilities:

  • Tracking and Processing County and Department Documentation
  • Reviewing documentation for compliance with regulatory and agency standards and to ensure they reflect a high level of care
  • Monitor the accuracy of records, documents, and billing and complete reconciliation of services as needed
  • Report any and all documentation deficiencies and/or compliance concerns to the AVP of Contract Compliance, Director of Compliance, Department VPs and Directors in a timely manner
  • Monitor, track and correct billed claims in Electronic Health Record (EHR) on a weekly basis
  • Enter Riverside and San Bernardino Billing into County Systems
  • Process Denied Claims on a weekly basis
  • Prepare Invoices for all county billings and monitor payment reports
  • Maintain and run Claim Reconciliation Reports
  • Process County Client Authorizations
  • Audits client charts on a monthly basis
  • Assist service delivery staff in completing/correcting documentation
  • Organize and prepare records for visits and audits
  • Actively participate in the agency’s Performance and Quality Improvement (PQI) Plan
  • Other related duties as needed

Why Should You Apply?

  • Our Mission- work for an organization that makes a real difference in people’s lives
  • Competitive pay
  • Several benefit options
  • Employee tuition reimbursement
  • Great training for staff

Join McKinley to Be Your Best H.U.M.A.N.

Skills Required

  • Bachelor's degree in Social Work, Psychology, Public Administration, or a related discipline
  • Prior quality assurance experience with knowledge of IBHIS and billing code requirements, or case management experience
  • Word processing, email, internet, basic office skills, and ability to learn clinical software
  • Microsoft Excel, Power BI, and Adobe Acrobat proficiency
  • Ability to pass a pre-employment physical examination, TB screening, and drug screening
  • Ability to commute to various sites on and off campus
  • Ability to work extended hours as needed
  • Ability to physically restrain children if needed
  • Successful DOJ, FBI, and Child Abuse Index checks
  • Insurability under the corporate automobile insurance policy
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The Company

What We Do

McKinley Children's Center is a nonprofit organization providing trauma-informed care, education, mental health, and family services across Southern California. Founded 125 years ago, the center offers specialized programs including non-public schools for special education, counseling, and residential services. Their mission is to lead with compassion to transform the lives of youth and families, empowering them to thrive and strengthen their communities.

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