Medical Billing & Claims Specialist

Spring Branch Community Health Center; Katy (TX); On-site; USD 36,000 - 48,000; Full time

Job summary

Spring Branch Community Health Center is seeking a Billing Clerk to audit medical, dental, and behavioral health claims and submit them electronically in a timely manner. The role includes collecting on outstanding claims and maintaining accurate accounts receivable in the practice management system.

The position requires a high school diploma, three years of medical office experience, and knowledge of Medicaid/Medicare and third-party payer submission.

Qualifications

• High school diploma or equivalent.
• Three years’ work experience in a medical office environment, including Medicaid/Medicare/third party payer claims.
• FQHC experience preferred.
• Experience with medical and dental terminology and CPT/ICD/HCPCS coding.
• HIPAA confidentiality compliance.
• Strong oral and written communication skills.
• Professional interaction with the public and organizational staff.
• Ability to handle multiple projects simultaneously.
• Proficient with computers, copier, fax, and 10-key input.
• Proficient in a practice management system and Microsoft Office.
• Basic accounting knowledge.

Responsibilities

• Prepare and timely submit medical, dental, and behavioral health claims.
• Apply insurance payments and perform adjustments for accurate AR records.
• Responsible for collections of insurance and patient balances.
• Review accounts and request adjustments or refunds as needed.
• Audit data in the practice management system for accuracy.
• Monitor AR aging reports and identify accounts needing attention.
• Stay current with Medicaid, Medicare, CHIP and other payer rules.
• Alert management to changes in payer regulations and impacts.
• Appeal or resubmit denied or rejected claims.
• Set up and maintain electronic claims submission software and run reports.
• Resolve billing errors and communicate AR issues to billing manager.
• Continuously seek ways to improve AR processes and daily operations.
• All staff participate in emergency and disaster response programs.

Skills

Communication

Confidentiality

Customer service

Multitasking

Professional demeanor

Medical terminology

Office software knowledge

Education

High school diploma or equivalent

Tools

Practice management system

Microsoft Office

10-key calculator

Fax/Copier equipment

Job description

Spring Branch Community Health Center is seeking a Billing Clerk to audit medical, dental, and behavioral health claims and submit them electronically in a timely manner. The role includes collecting on outstanding claims and maintaining accurate accounts receivable in the practice management system.

The position requires a high school diploma, three years of medical office experience, and knowledge of Medicaid/Medicare and third-party payer submission.