Billing and Coding Analyst - Surgical Subspecialty Clinic

About the role

This position provides billing and coding support within the Ambulatory Care Clinic System. Specialized clinic areas include ENT, plastic reconstruction, neurology, and urology.

Responsibilities

• Reviews electronic medical records initiated by a health care provider and ensures accuracy of diagnosis, procedure codes, and modifiers 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.
• Affirms 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.
• 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.
• Reviews application forms, supporting documentation, registration and billing for compliance with the sliding fee discount program.
• Performs other related duties as assigned.

Requirements

• 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.
• Previous paid, professional billing and coding experience working in a surgical environment.
• Must possess and maintain at least one of the following certifications: Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or Certified Coding Specialist-Physician (CCS-P).

Qualifications

• Education, Training, and Experience: Any combination of education and experience which has led to the acquisition of the required knowledge, skills, and abilities. Typically obtained through: 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), or Certified Coding Specialist-Physician (CCS-P).
• Desired: An associate or bachelor's degree in a business-related field.

Skills

• 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.

Benefits

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.

Pay

Tentative schedule opening date: March 23, 2026. Closing date: Continuous (Previously: April 3, 2026)

Schedule

Tentative schedule opening date: March 23, 2026. Closing date: Continuous (Previously: April 3, 2026)