Program Billing Specialist
About The Position
Working under the supervision of the Controller, the Program Billing Specialist is responsible for accurate and timely billing, claims submission, payment posting, collections follow-up, and revenue cycle activities for UAII's healthcare and community programs. The role collaborates with providers, clinical staff, finance personnel, and third-party payers to support billing accuracy, timely reimbursement, and compliance with applicable Federal, State, County, and payer-specific requirements. It includes processing claims, resolving denials, researching billing discrepancies, maintaining accurate billing records, and supporting the financial sustainability of UAII's healthcare and community services while providing exceptional customer service and following organizational policies and procedures. UAII is a Native American-led nonprofit serving American Indian and Alaska Native communities in Los Angeles County through healthcare and culturally centered programs. The organization provides physical, behavioral, and spiritual health services and emphasizes Indigenous values, including respect, community responsibility, cultural integrity, reciprocity, stewardship, and truth and transparency.
Requirements
- Current Certified Professional Biller (CPB) certification.
- At least two years of medical billing experience in a healthcare, clinic, hospital, FQHC, Tribal health program, Urban Indian Organization, or nonprofit healthcare environment.
- Knowledge of CPT, HCPCS, and ICD-10 coding standards.
- Experience billing Medi-Cal, Medicare, managed care plans, and commercial insurance carriers.
- Experience with claims processing, payment posting, accounts receivable follow-up, denial management, and appeals.
- Proficiency with Electronic Health Records (EHR), practice management software, and Microsoft Office Suite.
- Strong attention to detail and organizational skills, with the ability to maintain accurate records.
- Ability to maintain confidentiality and comply with HIPAA, HITECH, and other applicable privacy regulations.
- Knowledge of medical billing, reimbursement methodologies, and revenue cycle management.
- Knowledge of HIPAA, HITECH, and healthcare compliance requirements.
- Strong understanding of CPT, HCPCS, and ICD-10 coding principles.
- Strong mathematical, analytical, and problem-solving skills.
- Strong verbal and written communication skills.
- Ability to prioritize multiple tasks and meet deadlines.
- Ability to establish and maintain effective working relationships with staff, patients, vendors, and payers.
- Ability to work independently and as part of a team.
- Ability to provide excellent customer service.
- Eligibility to work in the U.S.
- Fingerprint clearance and post-offer drug test.
- Proof of hepatitis B vaccination and negative TB screening.
Nice To Haves
- Associate degree in Health Information Management, Medical Billing and Coding, Healthcare Administration, or a related field.
- Certified Professional Coder (CPC), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), or equivalent coding certification.
- Three or more years of medical billing experience.
- Experience working in a Federally Qualified Health Center (FQHC), Tribal Health Program, Indian Health Service (IHS), or Urban Indian Organization.
- Knowledge of HRSA, Medi-Cal Managed Care, and IHS reimbursement methodologies.
- Experience utilizing eClinicalWorks, NextGen, Athena, or comparable EHR systems.
Responsibilities
- Prepare, review, and submit medical, behavioral health, and related healthcare claims to insurance carriers, managed care plans, and government payers.
- Verify insurance eligibility, benefits, authorizations, and coverage requirements.
- Review documentation for billing accuracy and ensure appropriate claim submission.
- Monitor claim status and follow up on unpaid, denied, or rejected claims.
- Research and resolve billing discrepancies, denials, underpayments, and appeals.
- Post payments, adjustments, and patient transactions accurately and timely.
- Maintain accounts receivable and work assigned aging reports.
- Coordinate with providers and support staff to ensure complete and accurate documentation.
- Assist with patient billing inquiries and payment arrangements as appropriate.
- Maintain billing records in accordance with organizational policies and regulatory requirements.
- Prepare reports related to billing activities, collections, reimbursements, and revenue cycle performance.
- Comply with HIPAA, HITECH, Medicare, Medi-Cal, and payer-specific requirements.
- Participate in staff meetings, training activities, and quality improvement initiatives.
- Occasionally work evenings and weekends as needed for company events.
- Perform other duties as assigned.
Benefits
- Medical, dental, and vision coverage.
- Voluntary accident, critical illness, and hospital indemnity insurance plans.
- Company-paid short-term and long-term disability.
- Company-paid basic life insurance and AD&D.
- HSA and FSA.
- 403(b) retirement plan with 4% employer match.
- Employee Assistance Program.
- Bereavement and jury duty paid leave.
- Employee Wellness Program.
- Paid vacation: 12 days during the first two years.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
