SUMMARY:

Under the supervision of the Billing Manager, the Billing Specialist is responsible for collecting and posting payments, correcting and submitting claims, scrubbing and completing billing batches on a daily basis, responding to billing inquiries from patients, and maintaining effective communication about billing-related matters with clinic staff, billing manager, and the clinic. The Billing Specialist II supports patient-centered care by ensuring coordination with the primary care provider, specialist(s) and the patient to ensure optimal patient outcomes.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Maintains exemplary customer service skills with patients, vendors and co-workers.
• Collects payments from patients.
• Interacts daily with medical or support staff to ensure proper education and updates are given to assist billing in clean claim submission.
• Checks patients’ eligibility for a variety of programs.

• On a daily basis, posts payments from insurers to patient accounts; updates related spreadsheets.
• Performs other reasonably related duties as assigned

• Proofs and corrects claims prior to submission.
• Checks CenCal website weekly to follow up on denials and correct claims in order to ensure payment.
• Sends out monthly statements and resolves any returned mail.
• Transmits electronic claims weekly.
• Processes insurance authorizations as needed.
• Follows up on denials and other outstanding accounts receivable.
• May assist in training other employees on billing-related duties.

Other duties and responsibilities:

• Demonstrates understanding of and observe all SBNC policies, procedures, rules and regulations.
• Demonstrates successful work-related behaviors.
• Attends all required SBNC meetings and trainings.
• Interacts with patients, physicians, staff, vendors, and visitors in a positive manner that reflects the SBNC mission and philosophy.
• Keeps work area clean and orderly.

Qualifications:

Education:

High school diploma or equivalent. Medical coding training or equivalent.

Experience:

One year of medical front desk or medical billing experience is preferred. An equivalent combination of education and experience that provides the required knowledge and abilities will be considered.

Knowledge of:

• Medical Terminology.
• CPT and ICD-10 coding.
• Proficient with Windows, Word, and Excel.

Ability to:

• Bilingual English and Spanish.
• Learn billing requirements of all SBNC payers, and acquire an understanding of the electronic billing process.
• Follow verbal and written instructions.
• Communicate effectively, verbally and in writing.
• Use standard office equipment, including computer, copy machine, fax machine, and postage meter.

Physical Demands

• Medical Terminology.
• CPT and ICD-10 coding.
• Proficient with Windows, Word, and Excel.
• Bilingual English and Spanish.

• Learn billing requirements of all SBNC payers, and acquire an understanding of the electronic billing process.
• Follow verbal and written instructions.
• Communicate effectively, verbally and in writing.
• Use standard office equipment, including computer, copy machine, fax machine, and postage meter.

May be required to lift objects weighing up to 25 pounds. Sitting in a normal seated position for extended periods. Reaching by extending hand(s) or arm(s) in any direction. Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s), for example, using a keyboard. Communication skills using the spoken word. Ability to see within normal parameters. Ability to hear within normal range. Ability to move about.

These physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job unless providing such accommodations would result in undue hardship for SBNC.

Salary Range: $23.00 - $26.00 per hour