Western Sierra Medical Clinic is a mission-driven community health center providing high-quality primary care to pediatric and adult patients.
The Billing Specialist is responsible for timely submission of claims to insurance companies from a wide variety of medical providers and facilities, as well as monitoring and ensuring that payments for medical services are received in a timely manner. This role also serves as an intermediary between healthcare providers, clients, patients, and health insurance companies.
Key duties include:
- Reviewing patient charges for accuracy and completeness and obtaining missing information
- Identifying the correct party to bill, including secondary and tertiary insurance
- Performing coding and billing tasks in a computerized health information technology system
- Supporting provider and facility credentialing with third-party payers and maintaining organized files
- Assisting with third-party payer contracting duties
- Using electronic health records and paper records to complete billing tasks
- Processing claims and posting credit accounts accordingly
- Reviewing insurance payments for accuracy and contract compliance
- Working denied or partially paid claims to resolve discrepancies
- Managing assigned accounts and following up on outstanding claims
- Assisting patients and staff with sliding fee applications
- Communicating with providers, patients, insurance representatives, and other parties to resolve billing issues
- Preparing reports and forms as directed
- Performing administrative duties such as answering phones, faxing, filing, and basic internet/email tasks
- Submitting twice-daily claims batches to insurance carriers
- Preparing insurance adjustment reports for leadership
- Assisting with insurance contract renewals and additions
- Documenting pertinent information in the electronic medical record
- Supporting quality improvement efforts and interdepartmental team activities
Requirements & Qualifications
Minimum Qualifications
- High school diploma or equivalent
- Successful completion of a medical billing program
- Current Certified Medical Reimbursement Specialist (CMRS) certification
- One year of current experience within the last three years in a comparable job classification
- Computer literacy, including email, Microsoft Office, and data entry skills
- Ability to type 45 words per minute and use a ten-key calculator
- Knowledge of HIPAA regulations and strict confidentiality practices
- Knowledge of Medicare and Medicaid billing regulations and requirements
- Experience in an FQHC setting preferred
Desired Experience
- Proficiency with billing software and electronic health records
- Medical coding knowledge
- Ability to manage multiple tasks and prioritize responsibilities
Location
California, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 month ago