Billing Specialist III

002 Sea Mar Community Health Center; Washington (District of Columbia); On-site; USD 25,000 - 36,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Prescription coverage

Life Insurance

Long Term Disability

Employee Assistance Program (EAP)

Paid time off 24 days + 10 holidays

401(k) retirement options

Job summary

Sea Mar Community Health Centers is hiring a Billing Specialist III to manage medical, dental, and behavioral health charges. You will review, post, and follow up on claims, correct denials, rebill when needed, and ensure timely processing of payments. The role requires strong AR knowledge and healthcare billing experience.

Starting wage is $22.41 per hour, with Monday–Friday daytime schedule. Sea Mar offers a comprehensive benefits package and opportunities for career growth within a culturally

Qualifications

• Strong understanding of accounts receivable management in a healthcare setting.
• Knowledge of CPT, ICD-9, ICD-10, HCPCS, modifiers, coding and documentation guidelines.
• Excellent customer service, organizational and communication skills.
• Familiarity with Medicare Compliance and HIPAA requirements.

Responsibilities

• Import, review and post all medical, dental, and behavioral health charges.
• Process encounters and following up on missing encounters.
• Adjust sliding fee discounts according to policy.
• Follow up with insurance companies on claim corrections or outstanding accounts.
• Correct and rebill claims with appropriate methods (VRE, Portal, PM, etc.).
• Process payments, adjustments, and transfer of balances.
• Scan payment batches and supporting documentation.
• Ensure open batches are closed daily and respond to billing audit requests.

Skills

Accounts receivable management

Healthcare billing

Customer service

Education

Medical Billing and Coding certification

Tools

CPT

ICD-9/10

HCPCS

Modifiers

Medicare/Medicaid guidelines

Job description

Sea Mar Community Health Centers, a Federally Qualified Health Center (FQHC) founded in 1978, is a community-based organization committed to providing quality, comprehensive health, human, housing, educational and cultural services to diverse communities, specializing in service to Latinos in Washington State. Sea Mar proudly serves all persons without regard to race, ethnicity, immigration status, gender, or sexual orientation, and regardless of ability to pay for services. Sea Mar's network of services includes more than 90 medical, dental, and behavioral health clinics and a wide variety of nutritional, social, and educational services.

Sea Mar is a mandatory COVID-19 and flu vaccine organization Billing Specialist III

Key Responsibilities

• Import, review and post all medical, dental, and behavioral health charges.
• Process all medical, dental, behavioral health, and special programs encounter forms.
• Process all missing encounters.
• Adjust sliding fee discounts according to the sliding fee policy.
• Process all clean claims and correct and process all failed and rejected claims
• Follow-up with insurance companies on claim correction questions or on outstanding accounts
• Correct and rebill patient accounts billed with the incorrect insurance, plan or no insurance.
• Correct all denied claims and rebill using the appropriate method (VRE, Portal, PM, ect…)
• Follow-up on any mailed Medicare claim returns and paper generated denials.
• Import, review and post all payments, adjustments, or transfer of balances
• Assign all unassigned payments and prepayments to the appropriate patient account.
• Process all secondary insurance claims.
• Assist patients by answering questions about their account, resolving billing issues, processing payments, and appropriately updating the patient’s account.
• Scan all paper payment batches and support documentation including EOBs, denials, ect…
• Process all approved credit balances including overpayments made by payers and patients
• Process all approved clinic adjustment requests.
• Ensure open batches are closed each day.
• Respond timely to billing record requests and billing audit requests

Qualifications

Qualifications This position requires a comprehensive understanding of accounts receivable management in a healthcare setting. This position requires strong working knowledge of managed care plans, insurance carriers, referrals and precertification procedures. Also required is a strong working knowledge of CPT, ICD-9, ICD-10, HCPCS, modifiers, coding and documentation guidelines. Strong customer service, organizational and communication skills are essential to this position. In addition, strict adherence to write-off policies, refund policies and other accounts receivable policies as outlined in the Procedure Manual is required. This position requires an ability to prioritize multiple tasks simultaneously in an occasionally stressful environment. Also required are general computer skills, typing skills and a working knowledge of Medicare Compliance, OSHA and HIPAA.

EDUCATION AND TRAINING

Medical Billing and Coding certification require Sea Mar is an Equal Opportunity Employer and offers a competitive benefits package.

Starting Wage: $22.41 Work Schedule: Monday-Friday Hourly - Hourly Plan, 22.41 USD Hourly

What We Offer

Sea Mar offers talented and motivated people the opportunity to work in a dynamic and growing community health organization. Working at Sea Mar Community Health Centers is more than just a job, it’s a fulfilling career with opportunity for advancement. The fringe benefits surpass most companies. For example, Full-time employees working 30 hours or more, receive an excellent benefit package of:

• Medical
• Dental
• Vision
• Prescription coverage
• Life Insurance
• Long Term Disability
• EAP (Employee Assistance Program)
• Paid-time-off starting at 24 days per year + 10 paid Holidays
• 401(k)/Retirement options
• Exciting opportunity to work in a culturally diverse environment

Sea Mar is an equal opportunity employer.

Please visit our website to learn more about us at www.seamar.org.

Sea Mar Community Health Centers, founded in 1978, is a community-based organization committed to providing quality, comprehensive health, human, housing, educational and cultural services to diverse communities, specializing in service to Latinos in Washington State. Sea Mar proudly serves all persons regardless of their ability to pay for services. Sea Mar's network of services includes more than 90 clinics.