FQHC Medical Billing Specialist

First Choice Health Centers Inc • East Hartford, CT

2d • $18 - $25 • Onsite

About The Position

First Choice Health Centers is seeking a Billing Specialist to perform billing, coding, and collection activities for assigned providers, patients, and insurance accounts. The role coordinates all aspects of billing for multiple service lines, including medical, dental, behavioral health, optometry, podiatry, and OB/GYN. The position is located in East Hartford, Connecticut.

The role handles claim preparation and submission, payment review, billing discrepancy resolution, insurance follow-up, patient billing inquiries, account adjustments, and collection-related tasks. The specialist is expected to meet service-level and productivity requirements, provide strong customer service, maintain confidentiality, and comply with HIPAA and Clean Claims Act policies and procedures.

The schedule is primarily Monday through Friday, 8:00 a.m. to 4:30 p.m., with one late night until 6:00 p.m. and an earlier Friday end time of 3:00 p.m. The hourly pay range is $18.00–$25.00, based on factors including work experience and certifications. Employees must be vaccinated against COVID-19, subject to certain exemptions, and candidates must pass a pre-employment drug test that includes marijuana testing.

Requirements

• Knowledge of accounting and math skills.
• Knowledge of medical and billing terminology.
• Knowledge of EHR and electronic billing.
• Knowledge of 270/271 and 835/837 transactions.
• College-level education in Accounting, Finance, or Medical Billing; equivalent work experience may substitute for a degree.
• At least 2 years of billing or collections experience in a healthcare or insurance environment.
• Experience with Medicaid billing.
• Knowledge of ICD and CPT coding.
• Experience with Federally Qualified Health Center (FQHC) payment systems.
• Strong working knowledge of HRSA guidelines.
• Ability to meet service-level and productivity requirements.
• Must be vaccinated against COVID-19, subject to certain exemptions.
• Must pass a pre-employment drug test, including testing for marijuana.

Nice To Haves

• Experience with ICD-9/10 and CPT coding.
• Knowledge of healthcare carriers and payer requirements.
• Familiarity with billing software such as eClinicalWorks.

Responsibilities

• Prepare and submit billing data and medical claims to insurance companies.
• Ensure patient information is accurate and medical records are up to date.
• Maintain billing software, update rate changes, and generate financial reports.
• Resolve billing discrepancies and appeal denied claims.
• Assess financial summaries and identify discrepancies to support accurate billing.
• Prioritize tasks, stay organized, and meet deadlines.
• Check insurance payments for accuracy and compliance with contract discounts.
• Contact insurance companies about payment discrepancies when necessary.
• Identify and bill secondary or tertiary insurance coverage.
• Answer patients’ billing and insurance inquiries and handle complaints.
• Review accounts for possible assignment and make recommendations to the Billing Supervisor; prepare information for the collection agency.
• Maintain confidentiality and comply with HIPAA guidelines and regulations.
• Process claims and follow up with insurance companies.
• Review patient bills for accuracy and completeness and obtain missing information.
• Follow up on unpaid claims within the standard billing cycle timeframe.
• Review, research, and respond to correspondence from insurance companies, attorneys, and patients.
• Contact patients to obtain information or collect patient balances.
• Identify, verify, and document account adjustments according to established policies and procedures.
• Meet service-level and productivity requirements for account reimbursement, task resolution, and responses to inquiries.
• Maintain positive relationships with internal and external customers by providing superior customer service.
• Use medical and billing terminology.
• Follow Clean Claims Act and HIPAA policies and procedures.

Benefits

• Medical, dental, and vision insurance for employees working 30 hours or more.
• 20 days of vacation, 8 paid holidays, and 2 floating holidays per year.
• Retirement savings program, including a safe harbor 401(k) with up to a 4% company match after 6 months of employment.
• Company-paid life insurance.
• Voluntary term, whole life, accident, and critical care insurance.
• Complimentary premium Calm Health membership.
• Recognition programs.
• Paid Basic Life Support certification with renewal every 2 years.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree