Job Description
Job Description
BILLING ANALYST I & II
Department
Finance / Billing
Reports To
Billing Manager / Designee
Work Setting
Office-based; cross-department collaboration
Systems
Welligent, Covivitas, Availity, Inovalon, DMH Avatar (SIFT), Power BI
POSITION SUMMARY
Hillview Mental Health Center, Inc. is seeking a highly skilled Billing Analyst II with a strong background in Medi-Cal, Other Health Coverage (OHC), and Medicare billing processes, including familiarity with CalAIM. This position supports accurate and timely claims submission, eligibility monitoring, reconciliation, denial resolution, and management reporting. The ideal candidate brings advanced data analysis skills, including SQL and business intelligence tools such as Power BI, and can interpret eligibility statuses, investigate claims, and provide reporting that supports data-informed decisions.
ESSENTIAL DUTIES AND RESPONSIBILITIES
• Verify Medi-Cal eligibility bi-monthly for all clients and compile and report on clients with terminated coverage using Covivitas.
• Partner with program admissions and management staff to streamline eligibility checks, authorizations, audits, corrections, and claims submissions.
• Conduct weekly reconciliation of program and service data between Welligent and county electronic health record systems to ensure accuracy and compliance.
• Review, update, and implement billing procedures to support compliance with applicable local, state, and federal requirements.
• Submit timely weekly billing to the Los Angeles County Department of Mental Health (DMH) and third-party payers using systems such as Welligent, Inovalon, and Availity.
• Track and analyze billing data and maintain reports that support transparency in claims processing and payments.
• Investigate, track, and resolve denied and voided claims to support timely correction and reimbursement.
• Review SIFT data for claim accuracy within DMH/IBHIS and Welligent systems.
• Generate and distribute management reports identifying unfiled, pending, denied, and submitted claims.
• Attend relevant internal and external meetings and trainings to stay current on policies, procedures, and billing practices.
• Prepare routine documents and reports using Microsoft Word and Excel, including spreadsheets with pivot tables.
• Use SQL to extract, analyze, and manipulate billing data to identify trends, discrepancies, and opportunities for improvement.
• Develop dashboards and analytics reports using Power BI or comparable tools to highlight trends, denial patterns, and financial performance.
• Collaborate with leadership to provide actionable reporting and strategic analysis to improve billing operations.
• Continue developing claims resolution expertise and knowledge of applicable billing updates through professional development.
REQUIRED QUALIFICATIONS
• Minimum of three (3) years of DMH billing experience.
• Proficiency interpreting Medi-Cal, Other Health Coverage, and Medicare eligibility codes, including A, P, F, and C.
• Familiarity with CalAIM initiatives and related updates that affect billing and claims.
• Experience with DMH claiming timelines, including submission deadlines and resubmission protocols.
• Solid understanding of the Medicare appeals process.
• Experience with Avatar SIFT data and ability to stay current with CalAIM updates.
• Knowledge of Claim Adjustment Reason Codes (CARCs).
• Proficiency in Microsoft Word, Microsoft Excel (including pivot tables), and SQL.
• Familiarity with Power BI or Tableau for data visualization.
• Strong written and verbal communication skills.
• Excellent time management, organization, attention to detail, self-motivation, and proactive problem-solving.
PREFERRED QUALIFICATIONS
• Bilingual Spanish/English skills.
• Experience with Welligent or other electronic health record (EHR) systems.
• Background in healthcare collections.
• Typing speed of at least 35 words per minute.
• Knowledge of DMH medical record documentation requirements.
• Ability to provide cross-coverage and take on additional duties as needed.
KNOWLEDGE, SKILLS, AND ABILITIES
• Ability to analyze billing data, identify trends and discrepancies, and communicate findings clearly.
• Ability to investigate claim rejections, denials, and voided claims and coordinate resolution with appropriate teams.
• Ability to manage competing deadlines while maintaining accuracy and confidentiality.
• Ability to collaborate with Finance/Billing, admissions, program leadership, and other stakeholders.
• Ability to prepare clear reports, spreadsheets, dashboards, and written procedures.
SYSTEMS AND TOOLS
Welligent; Covivitas; Availity; Inovalon; DMH Avatar (SIFT); Power BI; Microsoft Word; Microsoft Excel, including pivot tables; and SQL.
WORK ENVIRONMENT
The position primarily operates in a professional office environment and requires regular use of computer systems, electronic billing platforms, spreadsheets, and reporting tools. The role involves frequent communication and coordination with internal departments, county systems, and third-party payers.
EQUAL EMPLOYMENT OPPORTUNITY
Hillview Mental Health Center, Inc. is an Equal Opportunity Employer. Employment decisions are made in accordance with applicable federal, state, and local laws.
HILLVIEW MENTAL HEALTH CENTER, INC. | Gateway to Recovery and Independence Since 1966
\nCompany Description
Overview
Group meeting at HillviewServing more than 2,000 clients, Hillview Mental Health Center empowers individuals affected by mental illness to flourish and live productive, fulfilling lives. Our staff of psychiatrists, nurses, clinicians, recreational therapists and case managers work collaboratively to provide individually tailored services for our clients. These services can include medication evaluation and treatment, individual or group therapy, case management, substance abuse treatment and crisis management.
In all of our interactions, we treat our clients with dignity and compassion, helping them to identify their needs and goals and maximize their strengths.
We understand that our clients have practical needs that affect their ability to recover and thrive. We work closely with government and nonprofit agencies to help our clients obtain housing, transportation, schooling, employment and other supportive services. Hillview Village, our permanent housing complex, provides a welcoming home to 85 low income, chronically homeless clients.
Mental illness impacts all facets of life. Without treatment, individuals may cope by engaging in unsafe and unhealthy behaviors such as substance abuse and crime. We have expertise in helping clients who suffer from drug or alcohol abuse, as well as in assisting those newly released from jail or prison to successfully re-enter society.
Company Description
Overview\r\nGroup meeting at HillviewServing more than 2,000 clients, Hillview Mental Health Center empowers individuals affected by mental illness to flourish and live productive, fulfilling lives. Our staff of psychiatrists, nurses, clinicians, recreational therapists and case managers work collaboratively to provide individually tailored services for our clients. These services can include medication evaluation and treatment, individual or group therapy, case management, substance abuse treatment and crisis management.\r\n\r\nIn all of our interactions, we treat our clients with dignity and compassion, helping them to identify their needs and goals and maximize their strengths.\r\n\r\nWe understand that our clients have practical needs that affect their ability to recover and thrive. We work closely with government and nonprofit agencies to help our clients obtain housing, transportation, schooling, employment and other supportive services. Hillview Village, our permanent housing complex, provides a welcoming home to 85 low income, chronically homeless clients.\r\n\r\nMental illness impacts all facets of life. Without treatment, individuals may cope by engaging in unsafe and unhealthy behaviors such as substance abuse and crime. We have expertise in helping clients who suffer from drug or alcohol abuse, as well as in assisting those newly released from jail or prison to successfully re-enter society.