What are the responsibilities and job description for the Healthcare Claims Specialist position at Vista Del Mar Child & Family Services?
Get to know us :
For over 100 years, Vista Del Mar Child & Family Services (VDM) has taken great pride in providing exceptional programs and services for children and families throughout LA County. VDM envisions a community where all children and families are equipped and prepared to live productive, fulfilling lives. We serve the most vulnerable in Los Angeles, many of whom have faced multi-generational inequities. Vista Del Mar is guided by core values of empowerment, equity, and excellence.
Culture :
At Vista Del Mar, our success is empowered by our staff, families, residents, and clients. We believe in the inclusion and liberation of marginalized communities, standing in unity for justice and recognizing long-standing systemic oppression. We acknowledge we are part of an unjust system and strongly advocate to change oppressive systems and the unconscious bias that affect staff, clients, and families in all communities. Vista is committed to developing a culture of healing, community care, and creating a sense of belonging. Our actions will be louder than our words.
Folks who are Black, Indigenous, people of color, LGBTQ , of a marginalized gender, disabled, parents, are / have been system-impacted, are immigrants, and anyone who has experienced systemic oppression, and / or gender-based violence are encouraged to apply.
Mission :
Vista Del Mar provides a trauma-responsive continuum of services to empower children, youth, and families in Southern California to lead fulfilling lives.
Role Overview :
The Claims Specialist - Quality Standards and Compliance (QSC) manages client information and funding eligibility of clients billed through the Los Angeles County Department of Mental Health (DMH) contract. The individual will be responsible for opening and updating client information in the Client Web Services (CWS) application, and for reviewing service claims submitted to the DMH's Integrated System Website, IBHIS.
WILLING TO TRAIN : Healthcare workers, Health Records, Health Administration
Essential Job Duties (other duties may be assigned) :
- Verify funding eligibility status of DMH clients at admission and on a monthly basis and maintain financial information in client's module on Electronic Health Record System (EHRS) file and financial file. Disseminate any changes to programs and consult on any updates of funding eligibility.
- Check admissions and discharges in EHRS reviewing client's administrative face sheet insuring data is complete.
- Maintain an organized system of your assigned program's clients to be able to track the status of needed information and insure there is follow up with programs as needed.
- Review the client IBHIS face sheet and financial information sent by programs ensuring all information is accurate and complete in EHRS. Submit all call information to Client Web Services (CWS).
- Review non-final saved charges in EHRS for any corrective action needed.
- Review Diagnosis and Financial Update Reports and Client Action Forms submitted for any client information that requires updating in CWS.
- Background of education and / or experience in an office setting equivalent to a college education.
- Experience with insurance and submitting mental health claims; previous experience with Department of Mental Health contracts a plus.
- Advanced computer skills
- Full benefits offered (Medical, Dental, Vision)
- FSA / Dependent Care and Supplemental benefits through The Standard
- 403(b) - 3% Employer contribution based off annual salary
- 4 Mental Health Days
- Up to 12 Paid Holidays
- Up to 25% for Cell Phone Discounts with 3 Major Carriers (AT&T, Verizon, Sprint)
What You Bring to VDM :
Salary commensurate with experience
Salary : $21.00 - $23.00 / hour
What Can We Offer You for All Your Hard Work?
Vista Del Mar's Credentials :
Our nationally recognized clinical programs have been awarded a Gold Seal by the Joint Commission, the highest level of accreditation possible. In addition, our educational facilities are fully accredited through the Western Association of Schools and Colleges (WASC), and our graduate degree program is recognized worldwide for its high quality of instructions.
Equal Employment Statement
Vista Del Mar is committed to the full inclusion of all qualified individuals. Therefore, all qualified applicants will be considered for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Vista Del Mar will ensure that persons with disabilities are provided reasonable accommodations as part of this commitment.
Salary : $21 - $23
