Base Pay:

$22.00 - $32.50 / hour

JOB SUMMARY

Responsible for ensuring accurate and appropriate medical and dental billing, claim submission, payment posting, and subsequent follow up on rejected or denied claims. Duties include charge entry, payment posting, and denial entry. Maintains accurate departmental files of fee tickets, bulletins, and other required documentation. Ability to run, read, and comprehend eligibility messages. Exhibits the four core values of respect, integrity, innovation and compassion.

JOB DUTIES AND RESPONSIBILITIES

• Works with other billing staff to initiate billing of claims, rebill as necessary, appeal denials, and modify payers as necessary, file paper claims, follow-up on accounts until zero balance.
• Review statements organized alphabetically. Task encounters for bad debt and write-off.
• Manual charge entry of paper fee tickets, i.e. Family Pact, CDP, hospital, and home visits.
• Utilizes EHR documentation to ensure accurate charge and code entry in case of conflict (denial).
• Accurate posting of payments and denial adjustments received from third parties and patients.
• Utilizes Medicare FISS system to follow up Medicare denied claims.
• Follows up on credit balance and unapplied credit reports.
• Requests adjustments to accounts based on organizational guidelines.
• Maintains required billing records, reports, and files.
• Assist with front office error resolution, including completion of assigned tasks.
• Tutor Front office on error correction and workflow management.
• Assist with telephone inquiries and provide information requested.
• Periodic feedback to Billing Manager and Revenue Cycle Manager.
• Backup for electronic claims submission.
• Scan explanation of benefits into system for reference.
• Monthly reporting to Billing Manager of status of assigned accounts older than 90 days based on A/R aging reports and participates in educational activities.
• Maintains strictest confidentiality.

SOFTWARE ACCESS

NextGen

EPM & EHR, M

\

Drive, Finance I:

\Billing \Fee Tickets, Medi-Cal, Medicare and Blue Cross Electronic Billing, FISS Medicare Online Billing Data, Availity, Partnership Health Plan, ADP EZLabor, Microsoft Office Suite. Ability software, Microsoft

TEAMS, NGS

Connex

KNOWLEDGE, SKILLS AND ABILITIES

• Ability to work without direct supervision.
• Ability to take directions and meet deadlines in a timely manner
• Knowledge of medical terminology, including CPT and ICD 10, and clinic systems
• Current knowledge of medical billing, accounting procedures and applications, particularly as they relate to FQHC operations and Encounter Rate Billing
• Knowledge of claims review, analysis, and quality assurance.
• Basic working knowledge of Microsoft Office, including Outlook, Excel, and Teams.
• Knowledge of commercial insurance and government reimbursement programs.
• Possesses good verbal and written communication skills.
• Multi-task oriented with attention to detail.

EDUCATION

A...