BILLING CLERK

Southern Indian Health Council, Inc•Alpine, CA

1d•$21 - $29•Onsite

About The Position

Under the supervision of the Billing and Supervising Coder, the Billing Clerk will provide assistance with billing and clerical support services, as well as receptionist functions to the Billing department.

Requirements

Certificate from a medical institute or an Associate of Arts or Science Degree and at least two (2) years of experience in Medical/Dental/Pharmacy/Behavioral Health field preferred.
Knowledge of medical terminology, anatomy and physiology, CPT, HCPCS, and ICD-10 coding experience required.
A valid California driver’s license required with application submission and must be maintained throughout employment.
Applicant must be insurable under SIHC vehicle insurance policy at the time of hire and throughout employment.
Certifications and/or licenses appropriate to the positions required education and profession must also be valid and maintained.
Applicants must have a reputation for honesty and trustworthiness.
Must be responsible and able to exercise good judgment, accept feedback and constructive criticism from supervisor, pay attention to detail, follow instructions, including the ability to interact effectively and communicate with patients and coworkers in a professional and courteous manner.
Must be highly confidential and work as a team with other staff.
Applicant should be sensitive to the needs of patients.
Strong customer service, team building, interpersonal, and organizational skills.
Ability to establish and maintain effective peer relationships with coworkers within the department, interdepartmentally, , and the public.
Must be able to express ideas clearly, concisely, address audiences effectively, and exercise balanced judgment in evaluating situations and making decisions.
Willing to be part of a team and cooperate in accomplishing department goals and objectives.
Ability to prioritize, meet deadlines, take initiative, be proactive, resourceful, and function in a rapidly changing environment.
Ability to work with people of all social and ethnic backgrounds and to resolve conflicts, negotiate situations and facilitate consensus.
Normal clinic/office environment.
Sit or stand for long periods of time.
Reach, bend, climb, stoop, lift up to 25 lbs. repetitive hand movement; use and view PC.
Reliable transportation and car insurance as required by the state.
Travel as needed.
Each employee plays a key role in creating a compliance culture at SIHC. Employees are expected to learn and comply with all SIHC policies and procedures.
One must have the ability to understand the implications and complexities of all compliance policies.
Participation in all compliance training is mandatory, and generally have a heightened awareness of policies and regulations that are specific to one’s department and position.
All SIHC employees are expected to report violations or suspected violations of compliance policies or regulations.
Applicants must successfully pass a pre-screening, including a tuberculin skin test or x-ray and a blood/urine drug screening test.
Health must be adequate to perform all duties of the position.
Applicants must complete SIHC Application and Authorization Form, both must be submitted to Human Resources prior to the close date indicated.

Nice To Haves

Prior billing and collection experience preferred.
Previous IHS/FQHC experience preferred.
NextGen Healthcare EHR/EMR experience preferred.

Responsibilities

Charge batches verification and pre-coding via PM/EHR.
Ensure all expected charges are received from providers.
Verify eligibility and authorization is obtained and correct insurance is present in PM.
Verify documentation has been received for all new patients and specialty programs (Grants, PRC, Direct) including demographics, insurance and claim information.
Verify appropriate use of CPT codes, ICD-10 codes and modifiers for all billable encounters.
Daily processing of claims and claim edits.
Correcting claim rejections through the clearinghouse.
Collection of outstanding balances from insurances and patients.
Creating EFT/Fiscal batches and posting corresponding insurance and patient payments.
Create, review and mail patient statements weekly.
Establish and maintain patient payment plans.
Check status of unpaid claims.
Provide additional documentation to get timely reimbursement.
Manage and prepare documents for accurate claims follow-up.
Review remit codes from EOB and ERA to identify denials and (zero) non-payments.
Follow up with payer on the routing of claims.
Communicate with the Billing and Coding Supervisor on all payer issues, problems and trends in a timely manner to guarantee resolution and reimbursement.
Document all follow up pertaining to the resolution of patient accounts.
Ability to work a flexible schedule may be required based on need.
Other duties as assigned.