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Job Description
CAREER DESCRIPTION
Sr. Medical Billing Specialist
SALARY INFORMATION
In addition to performance-based merit increases, this position is scheduled to receive a salary range increase on the following date:
Effective June 27, 2025 - 4.00% increase
Salary may be negotiable within the range listed above, based on position requirements and successful candidate's qualifications, subject to appropriate authorization.
OPEN TO THE PUBLIC
This recruitment will establish an open eligible list. The eligible list established through this recruitment will be used to fill current/future vacancies in Auditor-Controller and/or any other agencies within the County of Orange. This recruitment may also be used to fill positions in similar and/or lower classifications.
DEADLINE TO APPLY
Qualified applicants are encouraged to apply immediately, as the recruitment will close on
TUESDAY, JUNE 17, 2025, at 11:59 PM (PST).
ABOUT THE COUNTY OF ORANGE:
Whether it’s manicured beach towns or celebrated theme parks, all framed by oceanfront towns and luxury yachts, Orange County is commonly known as “The OC” and stands out as one of the state’s most iconic destinations. With a population of over three million residents, Orange County is the sixth largest county in the United States. Residents enjoy over 42 miles of pristine beaches, three major harbors, vast wilderness parks, beautiful nature preserves, and approximately 402 miles of riding and hiking trails. The OC is a destination region rich with top-notch universities and colleges, some of the highest quality public and private schools in the nation, many corporate headquarters and technology firms, and four international airports within an hour’s drive. Many world-class meeting and entertainment venues, convention centers, and some of the state’s most popular attractions such as Disneyland and California Adventure Resorts, Knott’s Berry Farm, and major sports franchises including the Anaheim Angels Baseball, Anaheim Ducks Hockey, the U.S. Men’s National Volleyball Team, and the 2012 Olympic Games Silver Medal winning U.S. Women’s National Volleyball Team call the OC home. Orange County embraces vibrant, historic, and diverse neighborhoods, and welcomes millions of visitors per year, truly making it where the world comes to live, work, and play.
Click here to learn more about the County of Orange.
AUDITOR-CONTROLLER
The mission of the Auditor-Controller Department is to promote public oversight, provide accountability, and support financial decision-making for the County. As the Auditor-Controller Department carries out its vision and mission, it will conduct business with the highest ethical and due diligence standards and demonstrate commitment to the public, other County departments and agencies, and its own employees.
You can learn more about the Auditor-Controller Department by clicking here .
HEALTH CARE AGENCY
Health Care Agency Accounting is part of the Satellite Operations Division of the Auditor-Controller Department that is responsible for providing accounting support services to the Orange County Health Care Agency (HCA) Department. The Medical Billing Unit, within the HCA Accounting Division, ensures that HCA is billing in compliance with federal and state guidelines and all billing deadlines are met and revenue collection is not jeopardized. The Medical Billing Unit supports all the coding, billing and collections activities on behalf of HCA.
You can learn more about the Health Care Agency by clicking here .
THE OPPORTUNITY
The Sr. Medical Billing Specialist is responsible for processing and submitting claims/bills to Medicare, third-party health plans and clients for services provided by HCA, in compliance with state/federal regulations. The Sr. MBS communicates with culturally diverse clients in resolving past due accounts for mental health and substance use disorder services. Collaborates with HCA program employees in the recalculation of annual fees (Universal Method of Determining Ability to Pay - UMDAP) due to a change in the financial position of a client. Reconciles client accounts to accurately reflect the correct balance due once the UMDAP has been determined. Prepares supporting documents for small claims court. Acts as a representative in small claims court on behalf of Orange County Health Care Agency, answering questions presented by the judge or negotiates a settlement with the client, prior to the hearing. The Sr. Medical Billing Specialist will perform claims follow up duties; researching claims not paid or underpaid claims, taking actions necessary. All HCA Accounting positions are assigned to the Auditor-Controller’s satellite accounting team at the Health Care Agency.
MINIMUM QUALIFICATIONS AND CORE COMPETENCIES
One year of experience as a Medical Billing Specialist with the County of Orange.
Or
Two years of experience preparing and processing electronically-generated medical billing, preferably in a hospital, medical office, or public health setting. Education in the areas of medical billing, accounting, office services procedures or medical terminology may be substituted for up to six months of the required experience on the basis of one semester unit for one month of experience.
In addition to the minimum qualifications, the ideal candidate will demonstrate experience and/or training in the following areas below:
Technical Expertise- Thorough knowledge of Medicare, Medi-Cal and third-party commercial insurance billing guidelines and regulations
- Thorough knowledge of Reasonable Collection Effort guidelines
- Understanding of follow-up collection and pre-collection activities
- Reconciling complex client accounts using basic accounting principles
- Knowledge of medical terminology and/or Current Procedural Terminology (CPT)
- International Classification of Diseases (ICD)
- Experience with Microsoft Excel and Word, and medical billing systems
- Knowledge of Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Practices and HCA Policy
- Understanding of policies, rules, and regulations regarding County procedures
Analysis/Problem Solving- Analyzing complex client account balances for accuracy.
- Identifying bad debt accounts through work queues and/or reports.
- Identifying reasons of claims that are denied, unpaid or underpaid.
- Identifying and successfully resolving complex issues and problems efficiently.
- Reviewing claims and determining eligibility for insurance payment/refund.
- Reviewing client accounts and determining client out of pocket amounts/client refund.
Effective Communication- Effective and empathetic verbal communications skills.
- Interpreting detailed and complex information and explaining to people who are unfamiliar with it
- Strong ability to effectively communicate complex rules and regulations to the public, vendors, or those unfamiliar with county procedures.
- Excellent oral and written communication skills are required with the ability to represent HCA in small claims court if necessary.
- Communicating with customers when a claim is denied or incomplete and follows through on pending issues to accomplish resolution.
MINIMUM QUALIFICATIONS
Please click here to be directed to the class specification for full details regarding the minimum qualifications for the Sr. Medical Billing Specialist.
NOTE: Foreign degrees require an evaluation of U.S. equivalency by an agency that is a member of the National Association of Credential Services (N.A.C.E.S.).
RECRUITMENT PROCESS
Human Resource Services (HRS) will screen all application materials to identify qualified applicants. After screening, qualified applicants will be referred to the next step and notified of all further procedures applicable to their status in the competition.
Application Screening (Refer/Non-Refer)
Applications and supplemental responses will be screened for qualifications that are highly desirable and most needed to successfully perform the duties of this job. Only those candidates that meet the qualifications as listed in the job bulletin will be referred to the next step.
Structured Oral Interview | SOI (Weighted 100%)
Applicants will be interviewed and rated by an oral interview panel of job knowledge experts. Each applicant's rating will be based on responses to a series of structured questions designed to elicit the applicant's qualifications for the job. Only the most successful candidates will be placed on the eligible list.
Based on the Department's needs, the selection procedures listed above may be modified. Candidates will be notified of any changes in the selection procedures
Please note: The information you provide on your application and/or response to the supplemental questions may be used as a scoring device, so please be thorough and complete in your response. "See Resume" is not a qualifying response and will not be scored in lieu of the required information.
Veterans Employment Preference Policy (VEPP)
The County is committed to providing a mechanism to give preferential consideration in the employment process to veterans and their eligible spouses and will provide eligible participants the opportunity to receive interviews in the selection process for employment and paid internship openings. Please click here (Download PDF reader) to review the policy.
Eligible List
Once the assessment has been completed, HRS will establish an eligible list of candidates. Candidates placed on the eligible list may be referred to a selection interview to be considered for present and future vacancies.
ADDITIONAL INFORMATION
Email is the primary form of notification during the recruitment process. Please ensure your correct email address is included in our application and use only one email account.
NOTE: User accounts are established for one person only and should not be shared with another person. Multiple applications with multiple users may jeopardize your status in the recruitment process for any positions for which you apply.
Candidates will be notified regarding their status as the recruitment proceeds via email through the GovernmentJobs.com site. Please check your email folders, including spam/junk folders, and/or accept emails ending with "governmentjobs.com" and "ocgov.com." If your email address should change, please update your profile at www.governmentjobs.com .
FREQUENTLY ASKED QUESTIONS:
Click here for additional Frequently Asked Questions.
For specific information pertaining to this recruitment, please contact Sam Apraku at 714-834-3116 or at Samuel.Apraku@ac.ocgov.com
EEO INFORMATION
Orange County, as an equal employment opportunity employer,
encourages applicants from diverse backgrounds to apply.
Non-Management Benefits
In addition to the County's standard suite of benefits, such as a variety of health plan options, annual leave and paid holidays--we also offer an excellent array of benefits such as a Health Care Reimbursement Account, 457 Defined Contribution Plan and Annual Education and Professional Reimbursement. Employees are provided a Retirement Plan through the Orange County Employees Retirement System (OCERS).
Please go to the following link to find out more about Defined Benefit Pensions and OCERS Plan Types/Benefits.
http://www.ocers.org/active-member-information
Click here for information about benefits offered to County of Orange employees.
Closing Date/Time: 6/17/2025 11:59 PM Pacific -
ABOUT THE COMPANY
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County of Orange
Show moreDiscover a Fulfilling Career at the County of Orange
With a population of over 3 million residents and 34 cities, Orange County is a thriving community known for its beautiful beaches, diverse culture, and strong economy. As the third-largest employer in the county, the County of Orange offers over 18,000 employees the opportunity to make a difference in their community and build a fulfilling career in public service.
As a County of Orange employee, you will have the chance to work in a variety of departments, each providing vital services to our community. From law enforcement and healthcare to public works and environmental protection, there is a wide range of career paths to explore. And with opportunities for advancement and professional growth, you can build a long and rewarding career with us.
As a top employer in the region, the County of Orange is committed to providing our employees with excellent benefits, including a competitive salary, flexible work schedules, and outstanding healthcare coverage. We also offer opportunities for career development and training, ensuring that our employees have the skills and knowledge they need to succeed.
Whether you're just starting your career or looking for a new challenge, the County of Orange is a great place to work. With a supportive and collaborative work environment, a commitment to excellence, and opportunities for growth and advancement, we invite you to join our team and make a difference in your community.
Community Impact:
Working for the County of Orange means you will have the opportunity to make a meaningful impact in your community. Whether you're providing critical services to residents, protecting the environment, or maintaining public safety, your work will make a difference in the lives of those around you.
Employee Wellness:
At the County of Orange, we prioritize our employees' well-being. We offer telecommuting options, generous health benefits, and wellness programs to promote work-life balance. We believe that by taking care of our employee’s health and well-being, we can help them excel in their careers while still enjoying their personal lives and taking care of their families.
Innovation:
The County of Orange is committed to embracing new technologies and innovative approaches to service delivery. We encourage our employees to think creatively and find ways to improve our processes and systems. If you're someone who loves to problem-solve and think outside the box, you'll find a supportive and dynamic environment here.
Collaboration:
Collaboration is key to our success at the County of Orange. We value teamwork, communication, and mutual support, and we work together across departments and functions to achieve our goals. If you're someone who enjoys collaborating with others and building strong relationships, you'll find a welcoming and inclusive community here.
Equality:
At the County of Orange, we are committed to creating a diverse and inclusive workplace where all employees feel valued and respected. Our Equity Policy reflects this commitment and guides our efforts to promote equity, diversity, and inclusion in everything we do.
Career Advancement:
The County of Orange is dedicated to helping our employees grow and advance in their careers. We offer a variety of training and development opportunities to help our employees reach their full potential. If you're looking for a place to build a long and fulfilling career, the County of Orange is an excellent choice.
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