Senior Billing Specialist

Roots Community Health Center•Oakland, CA

About The Position

The Senior Billing Specialist is responsible for accounts receivable follow-up, denial management, and payment posting to maximize reimbursement and ensure timely resolution of outstanding claims. This position focuses primarily on Alameda Alliance, Medicare, and Medi-Cal claims and supports training of front desk staff, new hires, and interns as needed. The position reports directly to the Billing Manager.

Requirements

High school diploma or equivalent required; Associate's or Bachelor's degree preferred.
Minimum of three (3) years of experience in medical billing, payment posting, or accounts receivable follow-up.
Experience working with Medicare, Medi-Cal, and managed care payers, including Alameda Alliance for Health.
Strong knowledge of insurance denials, appeals, and payer billing guidelines.
Proficiency in Electronic Health Records and practice management systems, preferably AdvancedMD.
Knowledge of medical terminology and healthcare reimbursement principles.
Strong analytical, organizational, and problem-solving skills.
Ability to train and support staff in registration and billing-related workflows.

Nice To Haves

Experience working in a nonprofit or community health center setting preferred.

Responsibilities

Review paper and electronic remittance advices (ERAs), explanation of benefits (EOBs), and denial notices.
Post insurance payments and contractual adjustments accurately in AdvancedMD.
Conduct accounts receivable follow-up on billed claims to ensure timely payment.
Research denied or underpaid claims and take corrective action toward resolution.
Correct claim errors and resubmit claims to payers as appropriate.
Investigate payment delays and unresolved claims to maximize reimbursement.
Review and update patient demographics, insurance plans, and carrier information.
Verify insurance eligibility and PCP assignment when necessary.
Maintain accurate demographic and insurance information in the electronic health record and billing system.
Monitor and report denial trends and reimbursement issues to the Billing Manager.
Participate in internal chart audits, billing audits, and compliance activities.
Implement payer billing guidelines, policies, and procedures.
Support front desk training as needed, including the development of tip sheets and desk references to assist the Patient Services Department.
Assist with onboarding and training of new hires and interns as needed.
Attend staff meetings, supervision sessions, and required trainings.
Complete assigned documentation and reports in a timely manner.
Perform other related duties as assigned.