Billing Specialist

Here at SNAHC, you are joining a team and company at a time of growth and transformation. You will love being surrounded by people who are as passionate as you are about healthcare and giving back to the community. Please note that individual total compensation for this position will be determined at the Company's sole discretion and the wage range for this role considers a wide range of factors including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. At SNAHC, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $18.97/HR-$25.66/HR. 

Position Summary:

The Billing Specialist I is responsible for the quality assessment of coding assignments. The Billing Specialist I is responsible for assisting in the processing of all types of payments, claims, denials, and ensuring that all necessary data is adjudicated in a timely manner.  This role is an integral part of our provider support team, providing documentation guidelines and updates,

Essential Functions:

• Coordinate the collection of data from point of origin; participate in the pre-processing of patient data to locate missing information and to make corrections as necessary.
• Submit claims on a daily basis.
• Post payments received.
• Share patient payment information on a daily basis.
• Review Sphere 2 provider training documentation.
• Point of contact for state programs including, but not limited to CHDP, Family Pact, Every Women Counts, etc.
• Process daily pending charges.
• Balance batch ledgers when necessary.
• Run and correct any claim edits.
• Run report to check for missing charges from providers.
• Serve as support and provide training for providers when needed.
• Work daily tasks from E.P.M. And E.H.R work logs.
• Stay current and update RCM with any payer specific or FQHC facility information changes.
• Reviews provider coding for accuracy in outpatient medical, dental and behavioral health records.
• Respond to all levels of coding questions.
• Analyze and resolve Revenue Cycle problems effectively by utilizing weekly aging reports to ensure all claims are adjudicated in a timely manner.
• Update patient records when necessary.
• Files and maintains transmittals for billing and auditing.
• Research problem claims, and adjust errors discovered therein.
• Review billing database for trends in claims rejections and resolve these as they occur.
• Review and resolve claim denials.
• Maintain high degree of confidentiality and respect in handling all clinic and client medical information.
• Purging charts that have aged out.
• Compliance with all state and federal laws and regulations, as they pertain to position including; HIPAA, sexual harassment, scope of practice, OSHA, etc.
• Other duties as assigned.

Minimum Qualifications:

• AA degree or equivalent experience in FQHC insurance, eligibility and/or billing.
• Experience with Medi-Cal, Medicare, and outpatient coding experience or equivalent combination of education.
• Familiarity with computerized Billing systems.

Preferred Qualifications:

• Certified Professional Coder (CPC) or Certified Biller.
• Knowledge and understanding of Community Clinic Third Party revenue processes, FQHC Billing experience.
• Knowledge, understanding and use of Electronic Health/Administrative Records, Resource Patient Management Systems NextGen.

Salary : $19 - $26