Billing Specialist III

Sea Mar Community Health Centers•Federal Way, WA

5d•Onsite

About The Position

Sea Mar Community Health Centers, a Federally Qualified Health Center (FQHC) founded in 1978, is a community-based organization committed to providing quality, comprehensive health, human, housing, educational and cultural services to diverse communities, specializing in service to Latinos in Washington State. Sea Mar proudly serves all persons without regard to race, ethnicity, immigration status, gender, or sexual orientation, and regardless of ability to pay for services. Sea Mar's network of services includes more than 90 medical, dental, and behavioral health clinics and a wide variety of nutritional, social, and educational services. We are recruiting for the following position: Sea Mar is a mandatory COVID-19 and flu vaccine organization Billing Specialist III This position is responsible for reviewing and posting charges, resolving failed claims and rejections, posting payments and adjustments, timely processing of secondary insurance, processing denials, bimonthly rebills, following up with insurance companies on accounts not paid, customer service, and collections of private past due accounts. This position is also responsible for ensuring accurate and timely processing of all third-party insurance, Medicaid, and private pay including special programs. Additionally, this position is responsible for training, supporting, and being a back-up for other medical, dental, and behavioral health billing personnel.

Requirements

A comprehensive understanding of accounts receivable management in a healthcare setting.
Strong working knowledge of managed care plans, insurance carriers, referrals and precertification procedures.
Strong working knowledge of CPT, ICD-9, ICD-10, HCPCS, modifiers, coding and documentation guidelines.
Strong customer service, organizational and communication skills are essential to this position.
Strict adherence to write-off policies, refund policies and other accounts receivable policies as outlined in the Procedure Manual is required.
An ability to prioritize multiple tasks simultaneously in an occasionally stressful environment.
General computer skills, typing skills and a working knowledge of Medicare Compliance, OSHA and HIPAA

Responsibilities

Import, review and post all medical, dental, and behavioral health charges
Process all medical, dental, behavioral health, and special programs encounter forms.
Process all missing encounters
Adjust sliding fee discounts according to the sliding fee policy
Process all clean claims and correct and process all failed and rejected claims
Follow-up with insurance companies on claim correction questions or on outstanding accounts
Correct and rebill patient accounts billed with the incorrect insurance, plan or no insurance
Correct all denied claims and rebill using the appropriate method (VRE, Portal, PM, etc.…)
Follow-up on any mailed Medicare claim returns and paper generated denials
Import, review and post all payments, adjustments, or transfer of balances
Assign all unassigned payments and prepayments to the appropriate patient account.
Process all secondary insurance claims
Assist patients by answering questions about their account, resolving billing issues, processing payments, and appropriately updating the patient’s account
Scan all paper payment batches and support documentation including EOBs, denials, etc.
Process all approved credit balances including overpayments made by payers and patients
Process all approved clinic adjustment requests
Ensure open batches are closed each day
Respond timely to billing record requests and billing audit requests
Run regular reports to ensure all claims are being properly billed and accounted for
Assist and back-up other business office staff as needed
Perform other duties and accept other responsibilities as assigned by the immediate supervisor