Billing Specialist

El Centro Family Health•Espanola, NM

10d•Onsite

About The Position

Under the direction of the Chief Financial Officer (CFO), the Billing Specialist collaborates with the External Billing Consultant and CFO, as needed, to carry out various clerical tasks related to maintaining clinic patient accounts. The role requires completing all work accurately and promptly, along with other related clerical duties as assigned.

Requirements

High School diploma or GED.
Proficiency in using computers and a 10-key calculator.
Bilingual in English and Spanish.

Nice To Haves

Two years of experience in medical or dental insurance billing.
Knowledge of billing practices, rules, and regulations for FQHC billing.
Pursuit of relevant certification is recommended.

Responsibilities

Oversee all billing activities, including posting, billing (both electronic and paper), payment posting, and collection of patient accounts.
Provide guidance to front-line staff and other billing team members regarding billing processes.
Collaborate with the Human Resources Department to ensure that all providers are properly accredited.
Manage the credentialing process for clinical practitioners associated with payer sources.
Review and verify provider notes, ensuring accurate coding for procedures and diagnoses.
Maintain and update the insurance configuration mappings within the practice management system.
Work closely with other departments to resolve billing issues that result in denials.
Receive payments for current and outstanding patient balances, prepare patient receipts, and generate finance report logs.
Reconcile all payments and checks received for the day with the amount deposited.
Process patient charges from both Electronic Practice Management (EPM) and paper encounters daily.
Open and close batches within the EPM system.
Review and correct data entered into the EPM system, including diagnosis codes, payer information, and patient demographics.
Verify the validity of Insurance/Payer identification numbers and patient eligibility, including re-enrolling patients into programs that cover services at the claim level.
Address data inconsistencies with other departments or clinics in a professional manner.
Respond to customer inquiries about billing and provide assistance as needed.
Perform general clerical duties, including correspondence.
Operate various office equipment, such as computers, printers, copiers, calculators, fax machines, and telephones.
Provide oral and written translation services in English and Spanish, as needed.
Perform additional tasks as assigned, including cross-training for departmental needs.