Performs complex clerical and accounting functions for patient billing including invoice verification, third party billing records maintenance, and problem resolution.
Processes claims for patients and payers, maintains documentation files, and follows up on submitted claims ensuring timely re-filing.
Responds to patient and insurance inquiries about billing via phone, in person, or writing.
Posts and reconciles payments to patient accounts, verifying insurance payments for accuracy per contracted fees.
Identifies and bills secondary and tertiary insurance companies.
Reviews accounts receivable and advises supervisor on delinquent accounts.
Analyzes patient records for unpaid visits.
Follows up on appeals, denials, and rejected claims with insurance carriers.
Maintains billing and filing records according to protocols.
Ensures confidentiality of financial records per HIPAA regulations.
Verifies CPT, HCPCS, and ICD codes comply with provider documentation, insurance, and regulatory guidelines.
Keeps current on ICD/CPT/HCPCS coding and FQHC-specific coding requirements to ensure revenue cycle best practices.
Promotes organizational core values of accountability, excellence, integrity, quality, and teamwork.
One year minimum experience in medical office setting and three years experience in medical billing is required.
Education includes high school diploma or equivalent; Medical Coding Certificate; RHIT or CPC by AAPC or AHIMA; meeting state licensure requirements.
Skills include knowledge of electronic medical records, Microsoft Office, communication, multitasking, detail orientation, and bilingual English/Spanish preferred.
Physical duties include sitting, standing, walking, lifting (up to 20 pounds), reaching, bending, talking and hearing for up to eight hours per day.
Minimum of one year experience in a medical office setting and three years prior experience in medical billing. Education includes a high school degree or equivalent, Medical Coding Certificate; RHIT or CPC from AAPC or AHIMA, and state licensure requirements. Computer proficiency in EMR software, Microsoft Office, and Google Drive. Excellent written and verbal communication skills. Ability to work independently and in teams. Organizational skills with attention to detail and multitasking ability. Preferred bilingual in English and Spanish. Knowledge of medical terminology, anatomy, physiology, government regulations, and insurance payer policies. Physical ability to lift 20 pounds and perform office duties for up to 8 hours a day.
Location
Texas, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago