Billing, Eligibility and Referrals Specialist 3915461
LifeLong Medical Care - Oakland, CA

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LifeLonfg Medical Care

About the Organization

The 2012 winner of the East Bay Express Reader’s Choice Award for best non-profit, LifeLong Medical Care provides high-quality health and social services in a positive, caring environment for individuals with limited income, as well as those who face significant barriers to attaining better health. More than twenty thousand people of all ages choose LifeLong for their health care each year, at sites located in Alameda, Contra Costa, and Marin Counties.

Position Summary

LifeLong Medical Care seeks an experienced Billing, Eligibility and Referrals Specialist for our School Based Health Centers. The Billing, Eligibility and Referrals Specialist prepares and submits required eligibility information for all patients, is responsible for tasks relating to accurate encounter entry and claims submission, as well as providing outside specialty referrals and following up on these referrals in a FQHC setting.

Essential Duties and Responsibilities

· Responsible for preparing all eligibility information for each scheduled clinic patient either the day before or immediately following the scheduled visit.

· Works with school staff to ensure that all scheduled and non-scheduled patients are checked for eligibility and that all information is entered accurately and thoroughly. This will require obtaining ARIES reports on students from school Office Managers.

· Assists patients in identifying and enrolling in new state and/or county programs.

· Contacts HMO’s, PPO’s, Medi-Cal/Medicare or other special funding sources to obtain authorizations to ensure reimbursement of services.

· Coordinates efforts with providers, MA’s, Medical Records and/or the Chart Prep Specialist to make sure report is received and placed in the chart.


· Strong organizational skills and ability to work effectively under pressure in a positive, friendly manner.

· Excellent verbal and written communication skills. Must be able to communicate at all levels.

· Demonstrated computer skills with MS Office and database programs.

· Knowledge of FQHC/medical office practices, health insurance billing procedures and programs, such as HPAC, FPACT, CHDP, BCCTP, Medi-Cal, Medicare, HMO/IPA insurances.

· Bilingual skills in English/Spanish required.

· Must have billing experience.

· Must have experience working with kids in a school environment.

Education and Experience

· High school graduate or equivalent . Some college preferred.

· Knowledge of medical terminology.

· Two years experience in a community health care environment or primary care setting.

· Experience with One e-App and Cal-Win.

· Knowledge of Medicare, Medi-Cal, HMO and PPO health insurance policies and procedures.

Competitive salary and excellent benefits: medical, dental, vision, Flexible Spending Accounts, dependent and domestic partner coverage, 403(b) retirement savings plan and tuition reimbursement program. To learn more about our health center, please see our website: .

This is a part time position (50% FTE) with benefits.

LifeLong Medical Care is an EOE

About this company
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LifeLong provides high-quality health and social services to people of all ages; creates models of care for the elderly, people with...