Billing Specialist I - Stockton, United States - Community Medical Centers Inc

Community Medical Centers Inc

Verified Company

Stockton, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

***The Billing Specialist I assists in maintaining the billing systems. The Billing Specialist I reports to the Revenue Cycle Director.

MINIMUM REQUIREMENTS

High school graduate or possession of a GED and one year of billing experience
or a billing certificate.
A billing certificate is not required but preferred. Work experience in a clinic or hospital setting or Federally Qualified Health Center is preferred.
Ability to use 10key, ability to type 35 wpm, applicant to provide typing certificate
Experience and knowledge of computerized medical or dental billing systems is preferred
Valid California Driver's license, proof of insurance, and personal transportation

SPECIFIC DUTIES

Responsible for maintaining the clinic billing of all patients to include charges, payments, adjustments, and any followup necessary for Self-Pay, Medi-Cal, Medicare, and third party payers.
Reviews patient chart documentation to assure correct coding and accurate billing.
Analyzing patient medical records to determine billable services based on payer. guidelines that include Medi-Cal, Medicare, Commercial, and State Specialty Programs.
Evaluate the accuracy of pending charges including dates of service, procedure, location, ICD10 CM, CPT, CPT II, CDT, HCPCS Codes and modifiers.
Ensure timely and accurate charge submission through electronic EHR charge capture.
Review first initial claim scrub before billing utilizing the practice management software.
Importing of Electronic payments from third party payers that include Medi-Cal, Medicare, Commercial, and State Specialty Programs.
Perform quality control of data entry to verify proper balancing/posting of payments to claims with accuracy and timeliness.
Runs reports that require monitoring of unpaid claims with the appropriate payer in an effort to collect outstanding claims.
Ability to identify billing errors and followup by notifying the appropriate Supervisor regarding rejected claims to identify a plan of action to process rebilling.
Verifying eligibility for third party payers that include Medi-Cal, Medicare, Commercial, and State Specialty Programs.
Performs followup procedures as necessary for all third party payers including Medi-Cal Medicare, and self

- pay patients questions.

Writes off credit balances as appropriate.
Compares insurance files with family insurance files to determine appropriateness of outofbalance.
As requested provides requested information for patient subpoenas.
Collaborate closely with Center Managers, clinical support staff, and providers with pending charge acceptance corrections.
Answer billing and charge related inquires by patients, CMC staff, and third party payers.
Runs a various types of reports as needed.
Performs other duties as assigned

PERFORMANCE REQUIREMENTS

Knowledge, Skills and Abilities

Knowledge of billing practices
Knowledge of clinic policies and procedures
Knowledge of coding and clinic operating policies
Ability to learn how to utilize Electronic Health Records and Electronic Practice Management systems.
Knowledge of Excel and Microsoft Word
Skill in using computer and calculator
Ability to examine documents for accuracy and completeness
Ability to prepare records in accordance with detailed instructions
Ability to work effectively with patients and coworkers
Ability to communicate effectively in verbal and written format
Listens skillfully and displays a willingness and ability to acknowledge the needs, expectations and values of others through the use of reflective listening and empathy conveyance. Responds to needs in ways that are helpful and beyond expectation.
Communicate effectively by using welcoming words, proper tone of voice, appropriate body language, eye contact and smiling with every interaction.
Ability to provide excellent customer service that is reflective of a culture that values trust and respect.

TYPICAL PHYSICAL DEMANDS
Requires sitting for long periods of time. Working in office environment. Some bending and stretching required. Working under stress and use of telephone required. Manual dexterity required for use of calculator and computer keyboard.

TYPICAL WORKING CONDITIONS
Normal office environment.