Billing and Coding Analyst - Surgical Subspecialty Clinic

Billing And Coding Analyst

Under general direction this position is responsible for providing billing and coding support within the Ambulatory Care Clinic System. The clinic areas of specialization include ENT, plastic reconstruction, neurology, and urology. This classification is a bridge between the Medical Billing Specialist series and the Coder-Certified classification. It differs from the Coder-Certified classification in that the former is responsible for reviewing the accuracy of billing codes which have been entered by providers into our billing system and the latter is responsible for reviewing provider notes in patient's charts to determine the correct billing code and entering into our billing system. Agency/Department: Health Care Agency - Ambulatory Care EDUCATIONAL/BILINGUAL INCENTIVE: Some positions may be eligible for educational incentive. This incentive may be 2.5%, 3.5%, or 5% for incumbents in eligible positions based on completion of an Associate's, Bachelor's, or Master's degree that is not required for the classification. Incumbents may also be eligible for bilingual incentive depending upon operational need and certification of skill.

Billing and Coding Analysts are represented by SEIU and are not eligible for overtime compensation. The eligible list established from this recruitment will be used to fill current and future Regular (including Temporary and Fixed-term), Intermittent, and Extra Help vacancies for this position only. There is currently one (1) regular full-time vacancy. Tentative Schedule Opening Date: March 23, 2026 Closing Date: Continuous (Previously: April 3, 2026)

Examples Of Duties

Duties may include but are not limited to the following:

• Reviews electronic medical records initiated by a health care provider and ensures accuracy of diagnosis, procedure codes, and modifiers in accordance with Federal and State regulations in compliance with billing and coding guidelines.
• Effectively monitors assigned work queues and reviews claim errors, ensuring timely and accurate resolution of accounts.
• Review, Analyze and validate medical records to ensure completeness and accuracy of code selections while identifying educational opportunities. Prepares educational materials to communicate with providers when identifying gaps in clinical documentation for the selection of appropriate diagnosis, procedure and modifiers
• Performs edit checks on data entered prior to transmittal and correct errors as indicated by using our standard reporting such as discharged, not final billed (DNFB) Correction Required, Late Charges, Suspended Charges, Encounters with and without charges, and Past Due Arrival or other specialized reporting including Eligibility.
• Ensures accurately coded data is integrated properly into the billing process timely while developing efficient workflows and streamlining the reimbursement. Collaborate with the billing staff to identify trends and improvement opportunities
• Conducts provider and staff training and on-going education on billing guidelines and audits the work of non-facility coders. Remains current with regulatory guidelines for billing and coding including health plans and coding updates.
• Review and Analyze denials, rejected claims, registration errors, missing authorizations and compiles training materials to educate the support staff for denial prevention and unnecessary claims rework.
• May be assigned multiple locations to ensure accurate and timely completion of assigned reporting and billing activities.
• Reviews application forms, supporting documentation, registration and billing for compliance with the sliding fee discount program.
• Participates in audit resolution, implementation and oversight of corrective action activities.
• Performs other related duties as assigned.

Typical Qualifications

These are entrance requirements to the examination process and assure neither continuance in the process nor placement on an eligible list. EDUCATION, TRAINING, AND EXPERIENCE: Any combination of education and experience which has led to the acquisition of the required knowledge, skills, and abilities. The required knowledge, skills, and abilities can typically be obtained by:

• Seven (7) years of hands-on working knowledge and experience performing professional medical coding and/or billing duties in a medical system comparable to the Ventura County Medical Center or an outpatient clinic providing high volume surgical specialty services similar to the Ventura County Ambulatory Care clinics.

NECESSARY SPECIAL REQUIREMENTS:

• Previous paid, professional billing and coding experience working in a surgical environment.
• Must possess and maintain at least one of the following:
• Certified Coding Specialist (CCS)
• Certified Professional Coder (CPC) as credentialed by the American Academy of Professional Coders (AAPC)
• Certified Coding Specialist-Physician (CCS-P) as credentialed by the American Health Information Management Association (AHIMA).

DESIRED:

• An associate or bachelor's degree in a business-related field.

Knowledge, Skills, and Abilities: Thorough knowledge of: common surgical specialties such as otolaryngology (ENT), plastic reconstruction, urology and neurology; surgical terminology; operative report structures related to surgery; medical reimbursement programs and complexity of payment systems; Current Procedural Terminology Codes (CPT) codes, International Classification for Diseases (ICD)-10 codes, Health Care Procedure Coding System (HCPCS) codes for payment processing of Medicare and/or Medi-Cal; Medi-Cal Provider Manual for Billing and Policy and Program and Eligibility; the Treatment Authorization Request (TAR) process; authorization requirements and processes of private health plans (such as Blue Cross/Blue Shield and Healthnet) and the Ventura County Health Care Plan. Ability to: interpret operative reports and surgical documentation; demonstrate open and direct communication with peers, managers, patients, and payers; review accounts for appropriate documentation, coding and billing information; evaluate and identify compliance and audit issues and work progressively with the compliance office to identify and resolve regulatory conflicts.

Recruitment Process

This is a continuous recruitment and may close at any time; therefore, apply as soon as possible if you are interested in it. Your application must be received by County of Ventura Human Resources Health Care Agency no later than 5:00 p.m. on the closing date. To apply on-line, please refer to our web site at hr.venturacounty.gov. If you prefer to fill out a paper application form, please call View phone number on click.appcast.io for application materials and submit them to County of Ventura Human Resources-Health Care Agency, 646 County Square Drive, Ventura, CA 93003. Note to Applicants: It is essential that you complete all sections of your application and supplemental questionnaire thoroughly and accurately to demonstrate your qualifications. A resume and/or other related documents may be attached to supplement the information in your application and supplemental questionnaire; however, it/they may not be submitted in lieu of the application. LATERAL TRANSFER OPTION: If presently permanently employed in another "merit" or "civil service" public agency/entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a "merit" or "civil service" style examination, then appointment by "Lateral Transfer" may be possible. If interested, please click here (Download PDF reader) for additional information. SUPPLEMENTAL QUESTIONNAIRE – Qualifying: All applicants are required to complete and submit the questionnaire for this exam at the time of filing. The supplemental questionnaire may be used throughout the exam process to assist in determining each applicant's qualifications and acceptability for the position. Failure to complete and submit the questionnaire may result in the application being removed from consideration. APPLICATION EVALUATION – Qualifying: All applications will be reviewed to determine whether the stated requirements are met. Those individuals meeting the stated requirements will be invited to the written examination. TRAINING & EXPERIENCE EVALUATION: A Training and Experience Evaluation (T&E) is a structured evaluation of the job application materials submitted by a candidate, including the written responses to the supplemental questionnaire. The T&E is NOT a determination of whether the candidate meets the stated requirements; rather, the T&E is one method for determining who are the better qualified among those who have shown that they meet the stated requirements. In a T&E, applications are either scored or rank ordered according to criteria that most closely meet the business needs of the department. Candidates are typically scored/ranked in relation to one another; consequently, when the pool of candidates is exceptionally strong, many qualified candidates may receive a score or rank which is moderate or even low resulting in them not being advanced in the process. ORAL EXAMINATION - 100%: A job-related oral examination will be conducted to evaluate and compare participating examinees' knowledge, skills, and abilities in relation to those factors which job analysis has determined to be essential for successful performance of the job. Examinees must earn a score of seventy percent (70%) or higher to qualify for placement on the eligible list. NOTE: The selection process will likely consist of an Oral Exam, which may be preceded or replaced with the score from a Training and Experience Evaluation (T&E), contingent upon the size and quality of the candidate pool. In a typical T&E, your training and experience are evaluated in relation to the background, experience and factors identified for successful job performance during a job analysis. For this reason, it is recommended that your