BILLING CLERK (Medical)

Ravenswood Family Health Network; Redwood City (CA); On-site; USD 33,000 - 50,000; Full time

Job summary

Ravenswood Family Health Network in Redwood City, CA is seeking a Billing Clerk I to prepare and submit billing for all payors, including self-pay patients, public programs, and private insurance. This entry-level position emphasizes accuracy and timely posting of payments.

The role requires a high school diploma and one year of billing experience in a healthcare setting; bilingual Spanish is a plus. Training provided with growth potential within RFHN.

Qualifications

• High school diploma or GED required with one year of billing experience in a health care organization.
• Knowledge of billing practices and clinic policies/procedures.
• Knowledge of CDA and ICD-10 coding for public programs and third-party payers.
• Knowledge of dental billing and relevant modifiers.
• Data entry skills and ability to use spreadsheets (Excel).
• Bilingual Spanish is preferred to communicate with patients and staff.

Responsibilities

• Review encounter forms for accuracy and completeness.
• Process billing for services to all payors including electronic claims and self-pay statements.
• Receive remittance advices, post payments, and reconcile cash flow.
• Research denials and rebills to secure prompt payment.
• Follow up on outstanding patient balances and make outreach calls.
• Attend trainings on billing and eligibility issues.
• Maintain billing manuals and update with new guidance.
• Handle calls regarding patient accounts and billing questions.
• Develop payment agreements with patients with director approval.

Skills

Billing knowledge

CDA & ICD-10 coding

Data entry

Microsoft Excel

Bilingual Spanish (preferred)

Education

High school diploma or GED

Tools

Microsoft Excel

Job description

O RGANIZATION

The mission of Ravenswood Family Health Network (RFHN) is to improve the health of the community by providing culturally sensitive, integrated primary and preventative health care to all, regardless of ability to pay or immigration status, and collaborating with community partners to address the social determinants of health.

POSITION SUMMARY

Responsible for the preparation and submission of billing for all payors including self-pay patients, public programs, and private third-party insurance. Conducts accounts receivable review and follow-up on all unpaid accounts to ensure prompt payment and performs other duties as required.

The Billing Clerk I is distinguished from the Billing Clerk II, in that the Billing Clerk I is an entry level training position. There are no requirements of previous experience in addition to the minimum qualifications of one year of billing experience in a healthcare organization. The Billing Clerk II, however, requires at least three years prior experience as a biller or billing specialist in a dentist's office or community clinic with progressively increased responsibilities in addition to the minimum requirements.

DUTIES AND RESPONSIBILITIES

To be performed in accordance with RFHN Policies and Procedures

• Reviews encounter forms for accuracy and completeness (dx codes/CDT codes/ to ensure that the encounter is accurate and billable. Returns incomplete encounters to the provider for correction.
• Reviews batches of charges entered for errors prior to posting.
• Processes billing for services to all payors including submission of electronic claims for public programs, hard copy claims on HCFA 1500's and UB 92's for private insurance, and hard copy statements for self-pay patients.
• Maintains all backup of original documentation including encounter forms, copies of hardcopy statements, and correspondence available for audit, upon request.
• Receives remittance advices for third party billing, sends check to accounting for deposit, reconciles remittance advices and posts payments in a timely manner to ensure cash flow.
• Researches denials, unpaid or partially paid claims, and rebills daily to insure prompt payment.
• Follows up one outstanding patient balances for any retro rebilling and calls patients to collect if no insurance available.
• Attends training seminars sponsored by the State or other payers to keep up-to-date on billing and eligibility issues.
• Maintains all billing manuals up-to-date by deleting outdated information and inserted new advice notices as they arrive.
• Handles calls regarding patient accounts and billing questions.
• Develops payment agreements with patients with the approval of the Director of Billing Cycle. Uses templates and work-flow documentation tools effectively to ensure that encounters are completely documented as well as enabling the collection of data for statistical reports.

Qualifications

QUALIFICATIONS

• High school diploma or equivalent (GED) required with one year of billing experience in a health care organization.
• Knowledge of billing practices as well as clinic policies and procedures.
• Knowledge of CDA and ICD-10 coding and billing requirements for public programs and third-party payers.
• Knowledge of specialist billing in dental.
• Understanding of special billing modifiers.
• Familiar with data entry, use of a calculator, and software to create spread sheets such as Microsoft Excel.
• Bilingual Spanish language skills: Not required, but highly preferred to facilitate communication with patients and employees.
• Ability to work effectively and cooperatively with other RFHN staff and patients.
• Ability to examine documents for accuracy and completeness.
• Ability to communicate clearly.
• Ability to prepare records in accordance with detailed instructions.
• Up to date with COVID-19 vaccines per current CDC guidelines strongly recommended.

The pay range for this position is $24.00 to $36.00 per hour. However, the final base pay will be determined upon a number of individualized factors such as (but not limited to) the scope and responsibilities of the position, job-related knowledge, skills, experience, education and certification levels, and departmental budget. We also consider internal equity with our current employees when making final offers.

Ravenswood Family Health Network is an equal opportunity employer.