Healthcare Billing Specialist AR & Denials

Ravenswood Family Health Center; Redwood City (CA); Presencial; USD 33.000 - 50.000; Tempo integral

Resumo da vaga

Ravenswood Family Health Center in Redwood City, CA seeks a Billing Clerk to prepare and submit billing for all payers and manage accounts receivable. You will review encounter forms, process claims (HCFA 1500s, UB-04s), and post payments to ensure cash flow.

Prior billing in healthcare and familiarity with EPIC/OCHIN is preferred; BLS certification is required. This position emphasizes accuracy, documentation, and timely follow-up on denials and unpaid claims, with opportunities to participate

Qualificações

• High school diploma or equivalent (GED) along with one year of billing experience in a health care organization required.
• Basic Life Support (BLS) certificate required.
• Experience with medical and dental billing for an FQHC (Federally Qualified Health Center) highly desirable.
• Knowledge of billing practices required.
• Knowledge of CPT and ICD-10 coding and billing requirements for public programs and third-party payers.
• Knowledge of CDA and ICD-10 coding and billing requirements for public programs and third-party payers.
• Understanding of special billing modifiers.
• Bilingual Spanish/English or Tongan/English skills not required, but highly preferred to facilitate communication with patients.
• Familiar with a Windows environment and specifically Microsoft Excel.
• Familiar with data entry, use of a calculator, and software to create spread sheets such as Microsoft Excel.
• Ability to work effectively and cooperatively with other RFHN staff and patients.
• Ability to examine documents for accuracy and completeness.
• Ability to communicate clearly.

Responsabilidades

• Reviews assigned encounter forms for accuracy and completeness before claims submission.
• Returns incomplete forms to the appropriate clinical staff for correction.
• Reviews batches of charges entered for errors prior to submitting.
• Processes billing for services to all payors, including submission of electronic claims for public programs, hard copy claims on HCFA 1500s and UB 04s for private insurance, and hard copy statements for self-pay patients.
• Maintains backup of original documentation, including encounter forms, copies of statements, and correspondence available for audit, upon request.
• Receives remittance advices for third party billing; sends checks 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 re-bills weekly to ensure prompt payment.
• Attends training seminars sponsored by the State or other payors to keep up-to-date on billing and eligibility issues.
• Responds to/answers all calls regarding patient accounts and billing questions.
• Develops payment agreements with patients as outlined in the Billing and Collections Policy.
• 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.
• Attends meetings and participates in committees as requested.
• Other duties as assigned and requested.

Conhecimentos

Communication

Attention to detail

Data entry

Formação

High school diploma or GED

Ferramentas

EPIC/OCHIN

Excel

Descrição da vaga

Ravenswood Family Health Center in Redwood City, CA seeks a Billing Clerk to prepare and submit billing for all payers and manage accounts receivable. You will review encounter forms, process claims (HCFA 1500s, UB-04s), and post payments to ensure cash flow.

Prior billing in healthcare and familiarity with EPIC/OCHIN is preferred; BLS certification is required. This position emphasizes accuracy, documentation, and timely follow-up on denials and unpaid claims, with opportunities to participate