Preparing and submitting billing data and medical claims to insurance companies
Familiarity with billing software like eClinicalWorks
Standard Job Duties:
Minimum Knowledge, Skills & Abilities Required:
2 + years of billing/collections experience in a healthcare of insurance environment.
COVID-19 considerations: Employees of First Choice Health Centers must be vaccinated against COVID-19. Certain exemptions may apply.
Identifying and billing secondary or tertiary insurances
Contact patients as needed to collect appropriate information or to collect patient balances.
Ensure service level and productivity requirements are met as it relates to reimbursement of accounts, resolution of tasks and response to inquiries etc.
Ability to assess financial summaries and spot discrepancies for accurate billing
Knowledge of medical and billing terminology
College level education in Accounting, Finance, Medical Billing. Equivalent work experience can be substituted in lieu of degree
Answering patients' billing and insurance inquiries, as well as handling complaints
Knowledge of accounting; math skills
Knowledge of 270/271 and 835/837
Reviewing accounts for possible assignment and making recommendations to the Billing Supervisor, also preparing information for the collection agency
Maintain positive working relationships with internal and external customers by providing superior customer service.
Knowledge of healthcare carriers and payer requirements
Prioritizing tasks to stay organized and meet deadlines
Processing claims and following up with insurance companies
Knowledge of EHR and Electronic Billing
Ensuring accurate patient information and up-to-date medical records
First Choice is a drug-free workplace. Candidates are required to pass a drug test, including testing for marijuana, before beginning employment.
Review, research and respond to correspondence from insurance companies, attorneys and patients
Knowledge of ICD and CPT coding
Utilize Medical and Billing Terminology.
Calling insurance companies regarding any discrepancy in payments if necessary
Reviewing patient bills for accuracy and completeness and obtaining any missing information
Adhere to Clean Claims Act and HIPAA policy and procedures.
Experience with ICD-9/10 and CPT coding is highly desired
Checking each insurance payment for accuracy and compliance with contract discount
Experience and Training:
Maintaining strictest confidentiality; adhering to all HIPAA guidelines and regulations
Following up on unpaid claims within the standard billing cycle timeframe
Experience with and knowledge of Federally Qualified Health Centers (FQHC) is preferred
Resolving billing discrepancies and appealing denied claims
Maintaining billing software, updating rate changes, and generating financial reports
Identify, verify and document account adjustments according to established policy and procedures.
Billing Specialist