Senior Billing Specialist

Senior Billing Specialist Roots Community Health Center - 3.0 Oakland, CA Job Details $32 an hour 1 hour ago Qualifications Appeals Medicare Managed care Managed care organization experience High school diploma or GED Electronic health record (EHR) management for billing and coding Medical insurance appeals management Medicaid Insurance claims appeal handling Medical terminology

Full Job Description Description:

Position Summary:

The Senior Billing Specialist is responsible for accounts receivable follow-up, denial management, and payment posting to maximize reimbursement and ensure timely resolution of outstanding claims. This position focuses primarily on Alameda Alliance, Medicare, and Medi-Cal claims and supports training of front desk staff, new hires, and interns as needed. The position reports directly to the Billing Manager.

Duties and Responsibilities:

Review paper and electronic remittance advices (ERAs), explanation of benefits (EOBs), and denial notices. Post insurance payments and contractual adjustments accurately in AdvancedMD. Conduct accounts receivable follow-up on billed claims to ensure timely payment. Research denied or underpaid claims and take corrective action toward resolution. Correct claim errors and resubmit claims to payers as appropriate. Investigate payment delays and unresolved claims to maximize reimbursement. Review and update patient demographics, insurance plans, and carrier information. Verify insurance eligibility and PCP assignment when necessary. Maintain accurate demographic and insurance information in the electronic health record and billing system. Monitor and report denial trends and reimbursement issues to the Billing Manager. Participate in internal chart audits, billing audits, and compliance activities. Implement payer billing guidelines, policies, and procedures. Support front desk training as needed, including the development of tip sheets and desk references to assist the Patient Services Department. Assist with onboarding and training of new hires and interns as needed. Attend staff meetings, supervision sessions, and required trainings. Complete assigned documentation and reports in a timely manner. Perform other related duties as assigned.

Requirements:

Qualifications and Competencies:

High school diploma or equivalent required; Associate's or Bachelor's degree preferred. Minimum of three (3) years of experience in medical billing, payment posting, or accounts receivable follow-up. Experience working with Medicare, Medi-Cal, and managed care payers, including Alameda Alliance for Health. Strong knowledge of insurance denials, appeals, and payer billing guidelines. Proficiency in Electronic Health Records and practice management systems, preferably AdvancedMD. Knowledge of medical terminology and healthcare reimbursement principles. Strong analytical, organizational, and problem-solving skills. Ability to train and support staff in registration and billing-related workflows. Experience working in a nonprofit or community health center setting preferred.