JOB OBJECTIVE
This position will work under the supervision of the Billing Manager. The Billing Specialist will be responsible for the completion of all tasks to ensure accurate, compliant and timely billing of patient charges for appropriate reimbursement from all sources, such as patients and all other third party payers. Billing Specialists will interact with a multi-cultural population of diverse socioeconomic backgrounds, ages, and level of education.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
The Billing Specialist is responsible for performing the following duties:
- Reviews charges, payments and adjustments to ensure accuracy and compliance with billing, coding and any contractual requirements
- Generates paper or electronic claims and submits them to all third party payers such as Medi-cal Medicare, private insurances and other programs
- Generates patient statements and collection letters
- Enters payments received from payers and patients in the practice management system
- Reviews claim rejection queue and resolves for resubmission
- Follows up on denied and unpaid claims; works closely with payers to provide any information necessary to receive payment
- Reviews and collects on overdue patient balances
- Answers questions from patients, staff and payers
- Reviews and processes requests for adjustments, corrections or refunds
- Prepares billing reports
- Collaborates and communicates with other team members to ensure efficiency of processes
- Maintains billing records
- Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
- EDUCATION, EXPERIENCE AND QUALIFICATIONS
- Must possess a high school diploma or equivalent. A certification or some college work in medical terminology, billing and coding, business or accounting, and business communications is desirable.
- Must have knowledge of Current Procedural Terminology (CPT) and International Classification for Diseases (ICD) codes; Medi-cal , Medicare and insurance billing knowledge or experience; insurance claim forms: paper or electronic.
- Minimum of six (6) months of billing and customer service experience required.
- Ability to operate a computer and basic office equipment (calculator, copy machine). Must be proficient in Microsoft Work/Excel.
- Ability to communicate professionally in writing and orally and must be able to read and understand oral and written instructions.
- Data entry and clerical skills (typing, filing) accurate spelling and grammar is necessary.
- Must possess excellent customer service skills and maintain effective working relationship with patients; peers, managers and payers.
- Bilingual English/Spanish is highly desirable.
- Capable to analyze and solve problems with minimal supervision.