BILLING CLERK (Medical)
About The Position
Ravenswood Family Health Network (RFHN) is a community health organization whose mission is to improve community health through culturally sensitive, integrated primary and preventive care for all, regardless of ability to pay or immigration status, and to collaborate with community partners on social determinants of health. Under direct supervision, the Billing Clerk prepares and submits billing for all payers, including self-pay patients, public programs, and private third-party insurance. The position also reviews accounts receivable and follows up on unpaid accounts to help ensure prompt payment. Work is performed in accordance with RFHN policies and procedures.
Requirements
- High school diploma or GED.
- At least one year of billing experience in a health care organization.
- Basic Life Support (BLS) certificate.
- Knowledge of billing practices.
- Knowledge of CPT and ICD-10 coding and billing requirements for public programs and third-party payers.
- Knowledge of CDA and ICD-10 coding and billing requirements for public programs and third-party payers.
- Understanding of special billing modifiers.
- Familiarity with a Windows environment, particularly Microsoft Excel.
- Familiarity with data entry, calculator use, and spreadsheet software such as Microsoft Excel.
- Ability to work effectively and cooperatively with RFHN staff and patients.
- Ability to examine documents for accuracy and completeness.
- Ability to communicate clearly.
- Ability to prepare records in accordance with detailed instructions.
- Up-to-date COVID-19 vaccines per current CDC guidelines are strongly recommended.
Nice To Haves
- Experience with medical and dental billing for a Federally Qualified Health Center (FQHC).
- Knowledge of EPIC/OCHIN.
- Bilingual Spanish/English or Tongan/English skills.
Responsibilities
- Review assigned encounter forms for accuracy and completeness before claim submission, and return incomplete forms to appropriate clinical staff for correction.
- Review batches of entered charges for errors before submitting them.
- Process billing for all payers, including electronic claims for public programs, HCFA 1500 and UB 04 paper claims for private insurance, and paper statements for self-pay patients.
- Maintain backup copies of original documentation, including encounter forms, statements, and correspondence, for audits upon request.
- Receive third-party remittance advices, send checks to accounting for deposit, reconcile remittance advices, and post payments promptly to support cash flow.
- Research denied, unpaid, or partially paid claims and rebill weekly to help ensure prompt payment.
- Attend training seminars sponsored by the State or other payers to stay current on billing and eligibility issues.
- Respond to calls regarding patient accounts and billing questions.
- Develop patient payment agreements as outlined in the Billing and Collections Policy.
- Use templates and workflow documentation tools to ensure encounters are fully documented and to support statistical reporting.
- Attend meetings and participate in committees as requested.
- Perform other duties as assigned and requested.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
