Medical Biller II

Harbor Community Clinic•Los Angeles, CA

1h•$26 - $28•Onsite

About The Position

Reporting to the Revenue Cycle Manager (RCM), the Medical Biller II is responsible for the billing and collection activities for the clinic’s primary care, pediatric, behavioral health, and dental services. This position works closely with providers, Front Office staff, and the Quality Improvement Department.

Requirements

At least 2–3 years of direct medical billing experience (FQHC experience strongly preferred).
Experience with an electronic health record (EHR) system required; eClinicalWorks experience preferred.
Understands CPT, CDT, HCPCS, and ICD-10 coding protocols, as well as Medi-Cal, Medicare, managed care, and private insurance requirements related to FQHC billing.
Must be bilingual and fluent in English and Spanish.
Must demonstrate good attendance and punctuality and complete all assignments timely.
Must have proficient computer skills, including Microsoft Office abilities, with intermediate Excel skills.
Must have a high level of accuracy, excellent analytical, problem solving and time management skills, and possess strong organizational skills.
Ability to adapt to changes in the clinic setting and insurance payer requirements.
Communicate effectively with providers, other staff, and outside vendors.
Work collaboratively in a team environment, have excellent writing skills and be able to prioritize effectively.
Must maintain confidentiality and handle sensitive information with discretion.
Must have the willingness and ability to adapt to change, including advances in technology.
Must be legally authorized to work in the United States.
Must successfully complete post-offer background screening and verification requirements.

Nice To Haves

Certified Professional Coder and/or Certified Professional Biller preferred.

Responsibilities

Reviews insurance information, financial classification, and eligibility for all claims prior to submission.
Understands insurance billing requirements, including Medi-Cal, Newborn Gateway, CPE, PE4PP, Family PACT, Medicare, commercial insurance plans, and various dental programs.
Understands the application of the Sliding Fee Discount Program, documents and reviews discrepancies with RCM to develop a correction plan for improvement.
Ensures that all conditions for claim submission have been satisfied, including but not limited to: accurate charges and financial class, authorization/certification information, demographic and insurance information.
Ensures complete filing and follow-up of encounter data submissions to health plans, IPAs, and other payers, including secondary and crossover billing.
Submits all claims, electronically or via paper forms (IHCFA 1500/UB04) to various payers in a timely manner.
Monitors, tracks, and communicates with providers to ensure progress notes are closed in a timely manner.
Responds professionally to billing inquiries from patients, payers, providers, and staff.
Tracks discrepancies in front office operations and provides feedback and recommendations for process improvements based on findings.
Thoroughly analyzes patient accounts to ensure patient balances are accurate.
Generates and submits patient statements monthly.
Reconciles and audits daily patient payment collections and ensures that sufficient change is available for patient transactions.
Posts and reconciles payments, charges, and adjustments to patient accounts.
Ensures that all denials are corrected, rebilled or adjusted in a timely manner.
Interprets and reviews insurance EOBs, determines claim denial reasons and follows up with corrections and appropriate actions.
Ensures compliance with HIPAA and payer-specific guidelines.
Assists with month-end billing close activities within 10 business days following month-end.
Participates in training and professional development opportunities to maintain up-to-date knowledge.
Works closely with Front Office staff (Patient Experience Specialists) on various projects.
Performs other duties as assigned.