BILLING CLERK

599d7f2c-ccd4-4853-ba54-3a77c0e05068•Alpine, CA

1d•$25 - $31•Onsite

About The Position

The Billing Clerk works in the Fiscal department in Alpine and provides billing and clerical support, as well as receptionist functions, to the Billing department. The position is supervised by the Billing and Coding Supervisor. It is full-time, hourly, and non-exempt, with a stated schedule of Monday through Friday, 8:00 AM to 4:30 PM. A flexible schedule may be required based on need. The role handles charge verification and pre-coding, eligibility and authorization checks, claim processing and corrections, payment posting, patient statements and payment plans, and follow-up on unpaid or denied claims. The Billing Clerk documents account follow-up and communicates payer issues, problems, and trends to the Billing and Coding Supervisor to support resolution and reimbursement. The position also requires compliance with SIHC policies and mandatory compliance training.

Requirements

A certificate from a medical institute or an Associate of Arts or Science degree.
At least two years of experience in the Medical, Dental, Pharmacy, or Behavioral Health field is preferred.
Knowledge of medical terminology, anatomy and physiology, CPT, HCPCS, and ICD-10 coding experience is required.
A valid California driver’s license is required with application submission and must be maintained throughout employment.
Must be insurable under the SIHC vehicle insurance policy at hire and throughout employment.
Certifications and/or licenses appropriate to the position’s required education and profession must be valid and maintained.
Must demonstrate honesty, trustworthiness, responsibility, sound judgment, attention to detail, confidentiality, and the ability to accept feedback and follow instructions.
Must communicate and interact professionally and courteously with patients and coworkers and be sensitive to patients’ needs.
Strong customer service, team-building, interpersonal, and organizational skills.
Ability to establish and maintain effective working relationships with coworkers, other departments, and the public.
Ability to express ideas clearly and concisely, address audiences effectively, and exercise balanced judgment in evaluating situations and making decisions.
Ability to prioritize, meet deadlines, take initiative, be proactive and resourceful, and function in a rapidly changing environment.
Ability to work with people of diverse social and ethnic backgrounds and to resolve conflicts, negotiate, and facilitate consensus.
Reliable transportation and car insurance as required by the state; travel as needed.
Ability to pass pre-screening, including a tuberculin skin test or X-ray and blood/urine drug screening.
Health adequate to perform all position duties.
Applicants must complete the SIHC Application and Authorization Form and submit both to Human Resources before the indicated closing date.

Nice To Haves

At least two years of experience in the Medical, Dental, Pharmacy, or Behavioral Health field.
Prior billing and collection experience.
Previous IHS/FQHC experience.
NextGen Healthcare EHR/EMR experience.

Responsibilities

Verify charge batches and perform pre-coding through PM/EHR.
Ensure all expected charges are received from providers.
Verify eligibility, authorizations, and correct insurance information in PM.
Verify documentation for new patients and specialty programs, including demographics, insurance, and claim information.
Verify appropriate use of CPT codes, ICD-10 codes, and modifiers for billable encounters.
Process claims and claim edits daily.
Correct claim rejections through the clearinghouse.
Collect outstanding balances from insurers and patients.
Create EFT/Fiscal batches and post related insurance and patient payments.
Create, review, and mail patient statements weekly.
Establish and maintain patient payment plans.
Check the status of unpaid claims.
Provide additional documentation to support timely reimbursement.
Manage and prepare documents for accurate claims follow-up.
Review remit codes from EOB and ERA to identify denials and zero-payments.
Follow up with payers on claim routing.
Communicate payer issues, problems, and trends to the Billing and Coding Supervisor in a timely manner.
Document all follow-up related to patient account resolution.
Perform other duties as assigned.
Learn and comply with SIHC policies and procedures, participate in mandatory compliance training, and report suspected or actual compliance violations.