Hospital Billing and Follow Up Specialist (Open & Promotional)

Salary : $79,352.00 - $99,236.80 Annually
Location : County of San Mateo, CA
Job Type: Regular
Job Number: E414BA
Department: San Mateo Medical Center
Opening Date: 10/28/2026
Closing Date: 11/23/2026 11:59 PM Pacific
Bargaining Unit: 37

Description
The San Mateo Medical Center is seeking an experienced Hospital Billing and Follow Up Specialist to perform difficult, technical, complex billing functions and business services support work. The successful incumbents will research and compliantly follow up on denied claims for services provided at SMMC hospital and clinics. Researching varies payer guidelines and regulations; manage and monitor a caseload of accounts; resolve billing questions with fiscal intermediaries, physicians, and others; enter, retrieve, and interpret data using a hospital billing system; prepare reports and maintain accurate records. The Hospital Billing and Follow Up Specialist successfully resolves hospital and physician claims while adhering to HIPAA and payer regulation. Lead direction of others is not a regular part of the job, although project or relief leadership may be required.
The ideal candidate will possess:

• Experience in hospital billing and Medicare account follow-up using EPIC.
• Proven experience with medical claims billing and follow-up, including two years of hospital and/or clinical billing and collections.
• Experience with Medicare and FQHC reimbursement.
• EPIC HER/Resolute experience.
• Knowledge of Medicare Part A and Part B billing requirements.
• Knowledge of hospital inpatient and outpatient billing, including UB-04/837I institutional claims.
• Knowledge of professional and clinic billing, including CMS-1500/837P professional claims.
• Knowledge of Medicare coverage guidelines, medical necessity, and documentation requirements.
• Knowledge of Medicare remittance advice, including CARCs and RARCs, and adjustment reason codes.
• Understanding of contractual adjustments, deductibles, coinsurance, and underpayments.
• Proficiency in the EPIC system.
• Ability to operate standard office equipment, personal computers, telephone equipment, fax machines, and scanners.

The current vacancy is a regular, full-time, vacancy.
NOTE: The eligible list generated from this recruitment may be used to fill future extra-help, term, unclassified, and regular classified vacancies.
Qualifications

Knowledge of:

• Medical terminology as related to patient services support work.
• Policies and procedures related to patient services, office support and hospital or clinic business office activities.
• Office administrative practices and procedures, including filing and the operation of standard office equipment.
• Basic business data processing principles and the use of word processing or computing equipment.
• Proper form for typed materials.
• Business arithmetic, including percentages and decimals.
• Correct English usage, including spelling, grammar and punctuation.
• Record keeping principles and procedures.

Skill/Ability to:

• Perform technical, specialized, complex or difficult patient services office support work.
• Organize, prioritize and coordinate work activities.
• Read, interpret and apply rules, policies and procedures.
• Organize, research and maintain patient and general office files.
• Establish and maintain effective working relationships with those contacted in the course of the work.
• Compose routine correspondence from brief instructions.
• Make arithmetic calculations with speed and accuracy.
• Use initiative and sound independent judgment within established guidelines.
• Operate standard office equipment, including a word processor, personal or on-line computer, and centralized telephone equipment.

Note: Specific positions may require the ability to type at a rate of 40 net words per minute from printed copy.

Education and Experience:Any combination of education and experience that would likely provide the required knowledge, skills and abilities is qualifying. A typical way to qualify is:

One year of journey level office support experience in a patient services setting.
Application/Examination
Open & Promotional. Anyone may apply. Current County of San Mateo and County of San Mateo Superior Court of California employees with at least six months (1040 hours) of continuous service in a classified regular, probationary, extra-help/limited term positions prior to the final filing date will receive five points added to their final passing score on this examination.
The examination process will consist of an application screening (weight: pass/fail) based on the candidates' application and responses to the supplemental questions. Candidates who pass the application screening will be invited to a panel interview (weight: 100%). Depending on the number of applicants, an application appraisal of education and experience may be used in place of other examinations or further evaluation of work experience may be conducted to group applicants by level of qualification. All applicants who meet the minimum qualifications are not guaranteed advancement through any subsequent phase of the examination. All examinations will be given in San Mateo County, California, and applicants must participate at their own expense.

IMPORTANT: Applications for this position will only be accepted online. If you are currently on the County's website, you may click the "Apply" buttonIf you are not on the County's website, please go to https://jobs.smcgov.org to applyResponses to the supplemental questions must be submitted in addition to our regular employment application form. A resume will not be accepted as a substitute for the required employment application and supplemental questionnaire

~ TENTATIVE RECRUITMENT SCHEDULE ~Final Filing Date: Monday, November 23, 2026 11:59PM PST
Application Screening: Week of November 30, 2026
Combined Civil Service Panel and Department Interviews: Week of December 14, 2026

Analyst: Debbie Kong (10282026) (Patient Services Specialist - E414)
We invite you to explore our page for a snapshot of the comprehensive and competitive benefits available to eligible employees of the County of San Mateo. From health and wellness to financial security, our benefits are designed to support you at every stage of your career. (Please note that benefits are subject to change.)

In addition to core benefits, the County is proud to offer a variety of wellness and professional development programs to help you grow both personally and professionally. Most of these enriching opportunities are available during work hours and come at no cost to you.

As a County employee, you'll also be covered by the federal Social Security system, earning valuable retirement benefits based on your salary and years of service.
01

IMPORTANT: Applicants for this position are required to submit responses to the following supplemental questions. Your responses will give us additional information about your background and experience related to this position and will be used in the selection process. Be concise and specific. Neatness, clarity of expression, grammar, spelling and ability to follow instructions will be considered in the evaluation process. A resume will not be accepted as a substitute for your responses.

• I understood the above statement. Proceed to supplemental questions.

02

A) List the types of government/ insurance billing and follow-up experience you have. B) Include how you became familiar with each type of government insurance billing. C) Be sure to include any experience with UB-04 and CMS 1500 claim billing.
03

Give one specific work-related example that best demonstrates your ability to resolve a difficult or complex billing problem. A) Why was the problem difficult or complex? B) What did you do? and C) What was the outcome? Be specific.
04

Describe your experience using Epic or other electronic health records system, particularly for hospital billing, insurance verification, claims processing, and account follow-up.
05

Please describe your specific experience with hospital revenue cycle. Please include responses to the following: what role did you play in the cycle; how your role supported compliant billing?
06

San Mateo County departments sometimes need Extra-Help or Limited Term workers in addition to permanent employees. Extra-help and Limited Term vacancies are excellent opportunities to gain exposure to the Division, apply and learn new skills and determine if you would be interested in a regular position in San Mateo County Health. Please select your interest in the following choices. Select all that apply.

• Extra-help vacancies - Extra-help assignments are at-will and the employee is paid on an hourly basis. Some extra help positions are eligible for benefits under the Affordable Care Act. Extra-help workers are not guaranteed permanent status at the end of the extra-help assignment.
• Limited Term vacancies - Limited term positions are at-will positions. Limited Term Employees are assigned to assignments not to exceed three years. They receive medical and dental benefits, similar to regular employees, and a defined contribution retirement plan.
• None of the above - Interested in Regular vacancies only.

07

How did you learn about this position?

• County of San Mateo Website
• County of San Mateo Job Interest Card Notification
• County Hosted Virtual Event
• County Hosted Job Fair
• CalOpps.org
• College/University Career Center
• Community-based Organization Posting
• Facebook/Instagram
• Friend or Relative
• GovernmentJobs.com
• Indeed
• Job Fair
• LinkedIn
• Professional Publication/Website (Please specify in next question)
• X (formerly called Twitter)
• Zip Recruiter
• Other (Please specify in next question)

08

If you answered, "Professional Publication/Website" or "Other" to the above question, please indicate below how you learned about this position. Your response to this question will help us in better marketing County jobs. Type NA if not applicable.
Required Question