Healthcare Billing & Denials Specialist

Sacramento Native American Health Center, Inc; Redding (CA); On-site; USD 30,000 - 44,000; Full time

Benefits offered by this job

Medical Insurance

Vision Insurance

403(b) Retirement Plan with employer 匹

Long-term Disability

Life Insurance

Flexible Spending Account

Paid Vacation

Paid Holidays

CME with stipend

Employee Assistance Program

Jury Duty Pay

Bereavement Pay

Prescription Discount Program

529 College Savings Plan

Educational Reimbursement

Teledoc for employees

Job summary

Shasta Community Health Center is seeking a detail-oriented medical billing specialist to ensure accurate charge entry, posting, and denial follow-up. Responsibilities include claim submissions, rebilling, and appeals using NextGen EPM & EHR.

The role requires knowledge of CPT/ICD-10, insurance payers, and strong Excel/Office skills. Experience with NextGen, Medicaid/Medicare billing, and revenue cycle processes is preferred.

Qualifications

• High school graduate 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, 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
• 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.

Skills

Attention to detail

Ability to work independently

Medical terminology knowledge

Communication skills

Billing and coding knowledge

Team collaboration

Education

High school diploma or equivalent

3 years of computer software experience

2+ years related experience (NextGen preferred)

Tools

NextGen EPM & EHR

M: Drive / Billing systems

Medi-Cal/Medicare billing

ADP EZLabor

Microsoft Office Suite

Job description

Shasta Community Health Center is seeking a detail-oriented medical billing specialist to ensure accurate charge entry, posting, and denial follow-up. Responsibilities include claim submissions, rebilling, and appeals using NextGen EPM & EHR.

The role requires knowledge of CPT/ICD-10, insurance payers, and strong Excel/Office skills. Experience with NextGen, Medicaid/Medicare billing, and revenue cycle processes is preferred.