Billing Control Clerk

NEW OP Template (PR & TLM MME / HR Enterprise) - Pay Calc 2.0; Redding (CA); On-site; USD 30,000 - 45,000; Full time

Benefits offered by this job

Competitive wages

Medical Insurance

Dental Insurance

Vision Insurance

403(b) Retirement Plan with employer 4

Long-term Disability

Flexible Spending Account

Paid Vacation

Paid Holidays

CME with stipend

Employee Assistance Program

Jury Duty Pay

Bereavement Pay

Health Club Discounts

Prescription Discount Program

529 College Savings Plan

Educational Reimbursement

Job summary

Shasta Community Health Center seeks a Billing Specialist to ensure accurate medical and dental billing, claim submission, and payment posting. You will handle denial follow-up, charge entry, and maintain billing records while upholding confidentiality in a busy healthcare setting.

Responsibilities include rebilling, appeals, and follow-up on accounts with aging reports. Strong knowledge of CPT/ICD-10 and NextGen experience is preferred.

Qualifications

• High school diploma or equivalent.
• 3 years' experience using computer application software.
• Minimum 2 years related experience, preferably with NextGen Program.

Responsibilities

• Works with other billing staff to initiate billing of claims, rebill as necessary, appeal denials, and modify payers as necessary.
• Review statements organized alphabetically; address bad debt and write-offs.
• Manual charge entry of paper fee tickets (e.g., Family Pact, CDP, hospital, home visits).
• Uses EHR documentation to ensure accurate charge and code entry in case of conflicts (denial).
• Post payments and denial adjustments from third parties and patients accurately.
• Follow up Medicare denied claims using the Medicare FISS system.

Skills

Medical billing

CPT/ICD-10 knowledge

FQHC operations

Microsoft Office

Communication skills

Education

High school diploma or equivalent

Tools

NextGen EPM & EHR

Medi-Cal/Medicare billing

Availity

ADP EZLabor

Microsoft Office Suite

Job description

Base Pay: $22.00 - $32.50 / hour

JOB SUMMARY Responsible for ensuring accurate and appropriate medical and dental billing, claim submission, payment posting, and subsequent follow up on rejected or denied claims. Duties include charge entry, payment posting, and denial entry. Maintains accurate departmental files of fee tickets, bulletins, and other required documentation. Ability to run, read, and comprehend eligibility messages. Exhibits the four core values of respect, integrity, innovation and compassion.

JOB DUTIES AND RESPONSIBILITIES

• Works with other billing staff to initiate billing of claims, rebill as necessary, appeal denials, and modify payers as necessary, file paper claims, follow-up on accounts until zero balance.
• Review statements organized alphabetically. Task encounters for bad debt and write-off.
• Manual charge entry of paper fee tickets, i.e. Family Pact, CDP, hospital, and home visits.
• Utilizes EHR documentation to ensure accurate charge and code entry in case of conflict (denial).
• Accurate posting of payments and denial adjustments received from third parties and patients.
• Utilizes Medicare FISS system to follow up Medicare denied claims.
• Follows up on credit balance and unapplied credit reports.
• Requests adjustments to accounts based on organizational guidelines.
• Maintains required billing records, reports, and files.
• Assist with front office error resolution, including completion of assigned tasks.
• Tutor Front office on error correction and workflow management.
• Assist with telephone inquiries and provide information requested.
• Periodic feedback to Billing Manager and Revenue Cycle Manager.
• Backup for electronic claims submission.
• Scan explanation of benefits into system for reference.
• Monthly reporting to Billing Manager of status of assigned accounts older than 90 days based on A/R aging reports and participates in educational activities.
• Maintains strictest confidentiality.

SOFTWARE ACCESS NextGen EPM & EHR, M:\ Drive, Finance I:\Billing \Fee Tickets, Medi-Cal, Medicare and Blue Cross Electronic Billing, FISS Medicare Online Billing Data, Availity, Partnership Health Plan, ADP EZLabor, Microsoft Office Suite. Ability software, Microsoft TEAMS, NGS Connex

KNOWLEDGE, SKILLS AND ABILITIES

• Ability to work without direct supervision.
• Ability to take directions and meet deadlines in a timely manner
• Knowledge of medical terminology, including CPT and ICD 10, and clinic systems
• Current knowledge of medical billing, accounting procedures and applications, particularly as they relate to FQHC operations and Encounter Rate Billing
• Knowledge of claims review, analysis, and quality assurance.
• Basic working knowledge of Microsoft Office, including Outlook, Excel, and Teams.
• Knowledge of commercial insurance and government reimbursement programs.
• Possesses good verbal and written communication skills.
• Multi-task oriented with attention to detail.

EDUCATION AND EXPERIENCE REQUIREMENTS

• High school graduate or equivalent.
• 3 years' experience using computer application software.
• Minimum 2 years related experience, preferably with NextGen Program.

BENEFITS

• Competitive Wages
• Medical Insurance
• Dental Insurance
• Vision Insurance
• 403 (b) Retirement Plan with matching employer contribution
• Long-term Disability coverage
• Accidental Death and Dismemberment Life Insurance
• Flexible Spending Account
• Paid Vacation
• Paid Holidays
• CME with stipend, for those eligible
• Employee Assistance Program
• Jury Duty Pay
• Bereavement Pay
• Health Club Membership Discounts
• Prescription Discount Program
• 529 College Savings Plan
• Educational Reimbursement
• Free Teledoc service for benefit eligible employees

Shasta Community Health Center is an Equal Opportunity Employer