Medical Billing Specialist jobs in Chico, CA

Job Title: Billing Specialist

Department: Business Office

Reports to: Business Office Supervisor/Revenue Cycle Manager

Organizational Peers: Business Office Staff

Supervisory Responsibilities: None

Position Details: Non-Exempt, Full Time, 40 hours/week

Pay Scale: $20-24/hr

Summary of Duties: Responsible for gathering charge information and entering into the data base, completing all of the billing processes, filing insurance claims, and working the aged accounts.

Essential Job Responsibilities:

• Reconciles account receivable claims using Athena Health electronic health records (EHR)
• Reconciles outstanding balances to determine appropriate course of action for various payers including Medicare, Medi-Cal, Worker’s Comp.
• Traces and appeals underpaid, and/or erroneously paid or denied claims with appropriate documentation according to the payer requirements.
• Verifies and adjusts accounts according to payer or program specifications.
• Performs collection actions and resubmits claims to insurance companies after corrections to minimize days in accounts receivable.
• Accurately documents claim issues.
• Prepares adjustments such as refunds, contractual differences, and write-offs for approval and processing.
• Audits, communicates and follows up with providers and staff to provide guidance in correcting errors related to denied or unpaid claims on continuing basis.
• Identifies and resolves issues with patient/payer billing issues and complaints.
• Continually strives to promote and maintain exceptional internal and external customer service.
• Monitors payer websites for medical policy benefit changes. Communicates changes to supervisor and staff.
• Reviews bulletins, newsletters and periodicals and attends workshop to stay abreast of current issues, trends and changes in laws and regulations governing claims, processing, coding and documentation.
• Provides suggestions to improve daily collection workflows and inefficiencies.
• Demonstrates working knowledge of ICD-10, CPT and HCPCS codes along with HIPAA laws and LCD/NCCI edits
• Complies with all company policies and procedures.
• Provides back up and support to team members as necessary.
• Works projects as assigned by management.
• Other duties as assigned.

Performance Requirements:

Knowledge:

• Knowledge of billing practices and clinic policies and procedures.
• Knowledge of coding and clinic operating policies.
• Knowledge of medical terminology.
• Knowledge of insurance industry.
• Knowledge of grammar, spelling, and punctuation.

Skills:

• Skill in establishing and maintaining positive, effective, internal and external working relationships.
• Skill in written and verbal communication.
• Skills in organization.

Abilities:

• Ability to understand and interpret policies and regulations.
• Ability to prepare documents in response to complaints and inquiries.
• Ability to accurately enter data.
• Ability to examine documents for accuracy and completeness.
• Ability to read, understands, and follows oral and written instruction.
• Ability to sort and file materials correctly by alphabetical or numeric system.
• Ability to communicate effectively and work with others.
• Ability to multitask.

Education: High school graduation or GED.
Experience: Preferred minimum of one year billing experience in health care organization