Medical Billing Clerk

Feather River Tribal Health, Inc.

Oroville (CA)

On-site

USD 33,000 - 34,000

Full time

14 days+

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Benefits offered by this job

Health Insurance

Dental & Vision insurance

401(k) with company match

Life Insurance

Paid Time Off 80 hours annually

14 Paid Holidays

Loan Repayment Assistance

Job summary

Feather River Tribal Health, Inc. is seeking a Billing Specialist to manage medical, behavioral health, and dental claims, posting payments, and correcting billing errors. The role requires experience with electronic billing systems and maintaining AR.

You will research denied claims and ensure timely reimbursements. The position emphasizes confidentiality, accuracy, and adherence to HIPAA regulations, with responsibilities across the full cycle of billing and reporting within FRTH's

Qualifications

High school diploma or equivalent.
Two years experience in Insurance billing.
Knowledge of HIPAA confidentiality requirements.
Ability to communicate clearly and concisely.

Responsibilities

Prepare billings for FRTH services using the billing system.
Transmit claims electronically and manually for payment.
Collect payments and handle insurance follow-up under supervision.
Break down patient charges into ethnic and insurance categories.
Maintain records of insurance regulations and updates.
Oversee related billing files and reporting.
Correct and resubmit denied/unpaid claims for payment.
Perform monthly closing and balancing of billing activities.

Skills

Communication

Interpersonal skills

Independence

HIPAA knowledge

Deadlines

Math calculations

Computer systems

Medical/dental terminology

ICD-10 CPT CDT coding

Cultural awareness

Education

High school diploma or equivalent

Job description

POSITION SUMMARY:

Under the direction of the Billing Supervisor, the duties of this individual include but are not limited to: billing and processing of medical, BHS and dental claims for all payer codes; maintenance of medical, BHS and dental accounts receivable for the organization including posting of payments utilizing an electronic billing system; correcting errors in billing; maintenance of insurance information for patients; patient and insurance refunds, processes payments received electronically and manually; researches denied or unpaid claims.

ESSENTIAL FUNCTIONS:

Prepares billings for services provided in the FRTH service departments utilizing a computerized billing system.

Transmission of claims electronically as well as manually for payment.

Under the direction of the Billing Supervisor, collects payments and answers all billing inquires and coordinates and performs insurance follow-up.

Breaks down all patient charges into ethnic and insurance categories.

Maintains records of all insurance related regulations, changes and updates.

Oversees maintenance of all related billing files.

Recommends bad debt accounts for referral to collection agency in a timely manner.

Under the direction of the Billing Supervisor, maintains and/or produces a variety of reports used in the tracking and billing of services including an aging report used for follow-up on all claims processed. Prepares monthly billing reports, and accounts pending diagnosis.

Corrects and/or researches denied or unpaid claims and resubmits for payment.

Performs monthly closing and balancing of billing activities based on schedules set by the Billing Supervisor.

Participates in quality improvement activities.

Respond and participate to inquiries regarding billing issues both on the phone and in person.

Maintains confidentiality in all matters.

At the time of hire, each employee will meet with their supervisor to set measurable goals and objectives that are a requirement for the position. These measurables will be monitored by the supervisor and reviewed during the introductory period. They will also be utilized in the annual performance evaluation. The measurables may change from year to year. The supervisor is responsible to notify the employee of any new measurables at the time of the performance review.

ADDITIONAL RESPONSIBILITIES:

Attend staff trainings and meetings as required.

Participates in the development of processes and evaluation of systems used by department.

Performs other related duties as needed.

Learn and implement electronic health records and billing functions as they continue to evolve.

Assist with a variety of duties in order to meet the needs of the department on an as needed basis.

Other duties as assigned.

KNOWLEDGE, SKILLS AND ABILITIES:

Ability to communicate clearly and concisely.

Human relation skills to deal effectively with patients, clients, staff, community members and visitors in a professional and courteous manner.

Ability to work independently and productively.

Demonstrate awareness, sensitivity and appreciation of Native American culture, traditions, customs and socioeconomic needs.

Knowledge of all confidentiality requirements as outlined in the HIPAA

Ability to maintain a professional attitude and appearance at all times.

Ability to meet deadlines and assigned projects in a timely, efficient manner.

Ability to make mathematical calculations quickly and accurately.

Ability to use a variety of equipment and computer systems necessary to perform duties.

Knowledge of medical and dental terminology, ICD-10, and CPT/CDTcoding.

EDUCATION AND EXPERIENCE:

High school graduate or equivalent.

Two (2) years experience in Insurance billing

PHYSICAL REQUIREMENTS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disability to perform the essential functions.

While performing the duties of this job, the employee is regularly required to use hands to finger, handle or feel; reach with hands and arms, stoop, kneel or crouch; and talk and hear within normal range. The employee is frequently required to stand, walk, sit, climb, or balance and use taste and smell senses. The employee must regularly be able to lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. This position is physically and emotionally challenging. There is a high degree of stress. Ability to deal with time constraints and emotional stress and exposure to body fluids and viruses are also essential functions of this job.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly exposed to odors and airborne particles. The noise level in the work environment is usually moderate.

Feather River Tribal Health, Inc. is a drug and alcohol-free workplace. As a federally funded Tribal Health Program, FRTH must comply with Executive Order No. 12564 (Sept. 15, 1986)(51 F.R. 32889 (requiring a Drug Free Workplace) and the Drug Free Workplace Act of 1988 (U.S.C. 8101-8106). As such, FRTH does require drug testing at the time of hire and upon reasonable suspicion after hire. All FRTH employees are required to comply with FRTH’s drug free workplace policies and applicable federal laws as a condition of employment.

Reasonable accommodations will be given to qualified disabled applicants pursuant to Section 501 of the Rehabilitation Act of 1973, 29 U. S. Code 791, Title 29, and the Americans with Disabilities Act (ADA).

Compensation & Benefits: