Vista Del Mar · 11 hours ago
Claims Specialist
3200 Motor Avenue, Los Angeles 90034
Full-time
Onsite
New Grad, Entry Level
$21/hr - $23/hrVista Del Mar Child & Family Services has been providing exceptional programs and services for children and families throughout LA County for over 100 years. The Claims Specialist will manage client information and funding eligibility for clients billed through the Los Angeles County Department of Mental Health, ensuring accurate claims submission and compliance with financial requirements.
Non ProfitFamily & CareHealthcareWellnessFamilyHealth CarePersonal Health
Responsibilities
Verifies funding eligibility status of DMH clients at admission and on a monthly basis, and maintains financial information in client’s TIER file and financial file. Disseminates any changes to programs and consults on any updates of funding eligibility
Daily, checks admissions and discharges in TIER, reviewing client’s administrative face sheet to ensure that data is complete. Maintains an organized system of assigned program’s clients to be able to track the status of needed information and ensure there is follow-up with programs as needed
As new clients are ready to be billed, reviews the IBHIS face sheet and financial information sent by programs to ensure that all information is accurate and complete in TIER. Submits all call information to Client Web Services (CWS)
Daily, reviews non-final saved charges in TIER for any corrective action needed. Completes any updates or corrections required, and manually updates services charges and ‘final save’ so that claims can be batched
Daily, reviews Diagnosis and Financial Update Reports and Client Action Forms submitted for any client information that requires updating in CWS. If TIER data is complete, submits the call to update CWS
Monthly, runs Non-Final Saved Notes reports for programs assigned, reviews notes for action required., and disseminates to programs
Reviews Final Saved Charge reports before batching claims for electronic submission to DMH. Ensures that claims are submitted to the correct funding source, all claim data is accurate, and has been collected
Batches together all reviewed claims and submits to DMH’s IBHIS website. Monitors the receipt of claims by IBHIS for any rejected claims, and follows necessary protocols to fix the rejected claims and resubmit them
Qualification
Required
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
Must have good organizational skills and the ability to work cooperatively with others
Advanced computer skills
Benefits
Full benefits offered (Medical, Dental, Vision)
FSA/Dependent Care FSA and Supplemental benefits
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)
Company
Vista Del Mar
Vista Del Mar provides family-centered social, educational & behavioral health services to empower children, youth, and families.
Founded in 1908
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Lena Wilson
CEO/President
Recent News
24-7 Press Release Newswire
2025-01-22
Company data provided by crunchbase