Billing Representative II

Primary Health Care Inc•Des Moines, IA

10h•Onsite

About The Position

Primary Health Care (PHC) was founded in 1981 by Dr. Bery Engebretsen in Des Moines, IA. Our mission has remained unchanged since that time, to provide healthcare and supportive services to all, regardless of insurance, immigration status, or ability to pay. Based on the needs of the communities we serve, PHC offers a spectrum of medical and dental services including family practice, behavioral health, HIV care and services, and pharmacy. PHC’s Homeless Support Services is the entry point for serving people experiencing homelessness in Polk County. Enabling services are available to help patients with benefits enrollment, case management, transportation, translation, and patient education. We currently have locations in Ames, Des Moines, & Marshalltown. As a Billing Representative II, you will be responsible for billing claims and addressing denials on behalf of Primary Health Care, Inc. Responsible for completing work queues as well as daily, weekly, and monthly tasks related to the full billing cycle. Ensures compliance with all State, Federal, and third-party payer requirements regarding confidentiality and billing. Responds promptly to billing or patient account inquiries. Demonstrates PHC’s iCare values in daily work.

Requirements

Associate degree. Equivalent experience may be considered in lieu of the required education.
At least 2 years of experience in healthcare billing and use healthcare billing software or a related field.
Experience working with CDT/CPT codes for all dental/medical insurance carriers.
Experience working with CDT/CPT and ICD-10-CM coding related to managed care programs and dental/medical billing requirements.
Experience working with dental/medical insurance contractual agreements, Medicare and Medicaid regulations, payment, and recoupments.
Reading and analysis skills with the ability to interpret remittance advice with remark codes and denial information.
Strong technical knowledge and expertise.
Excellent written and verbal communication skills.
Exceptional interpersonal and customer service skills.
Training and facilitation skills.
Advanced computer proficiency, including use of email, word processing, and spreadsheet applications.

Nice To Haves

Experience using Epic software as well as medical practice management software for a billing office.
Experience in all aspects of billing within both a clinical and hospital setting.
Experience in a Community Health Center/FQHC.
Supervisory skills.
Proficiency in computerized patient accounting applications.
Medical Billing Certificate, Certified Professional Coder preferred.
Fluency in spoken English and Spanish, with the ability to communicate clearly and accurately in both languages.

Responsibilities

Accurately bills claims for medical, dental, and hospital services provided by PHC. Updates patient charts with new or updated information and completes any associated back-billing.
Addresses denials and rebills claims to maximize revenue for the organization.
Completes daily entry of inpatient demographics, ICD10 and HCPCS codes, and charges into EHR; ensures inpatient claims are completed by providers, and follows up as necessary on missing charge tickets.
Works collaboratively with OCHIN Billing Services representatives, responding promptly to work queues and inquiries on accounts by patients or third-party payors.
Ensures compliance with all State and Federal patient financial service requirements, including, but not limited to, patient rights, confidentiality, and third-party billing.
Supports Billing Representative I in responding to inquiries on patient accounts.
Performs other duties as assigned.