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Billing Specialist

4 months ago

San Francisco, United States Mission Neighborhood Health Center Full time
Job DescriptionJob Description

The Mission Neighborhood Health Center (MNHC) is a non-profit, multi-site community health organization offering comprehensive health services in the Mission and Excelsior Districts of San Francisco.  The center offers primary health care services, adult medicine, pediatrics, family planning, OB/GYN, HIV and homeless services. 

We advocate for health equity and deliver innovative, high-quality services responsive to the neighborhoods and diverse communities we serve with a focus on the Latino Spanish-Speaking Communities.

We are currently looking for qualified candidates for our Billing Specialist role. This position reports to the Chief Financial Officer and is a Regular, Full Time, Non-Exempt role with a starting hourly rate of $27.52 with full benefits. This role is 100% onsite five days a week.

Primary Objective:

The Billing Specialist is responsible for entering and coding patient services into practice management system and reconciling the billing process to ensure invoices are generated and sent to the appropriate payer.  Sorts and files paperwork, handles billing inquiries, and performs follow-up duties.

Essential Functions/Responsibilities:

  1. Checks, researches and verifies encounter data for accuracy and completeness and obtains any missing information from providers and other locations and/or requests corrected information as needed.
  2. Codes information about procedures/diagnosis and keys charge information into practice management system.
  3. Manually maintains tracking system for non-computer-generated encounters, i.e. Lab/Xray.
  4. Identifies and tracks EHR/Front-end data errors and reports weekly to manager.
  5. Provides feedback to providers and front-end staff on data errors in the form of tasking and emails.
  6. Assists with coding and error resolution.  Conducts coding reviews with providers regarding coding guidelines.
  7. Identifies and resolves patient billing complaints or inquiries via phone.  Assists in answering billing-related inquiries, including working in the Credit and Podiatry Office.
  8. Researches, corrects, and tracks denials and claim rejections.  Appeals unpaid and denied claims as necessary.  Researches and provides accurate coding for rejected claims.
  9. Monitors reimbursement of payers on a continuous basis and identifies changes in reimbursement patterns.
  10. Performs collections on outstanding accounts by contacting patients and other third-party payers by phone and written correspondence.  Follows and reports status of delinquent accounts.
  11. Responds to correspondence from payers and follows up on requests for information.
  12. Conducts periodic medical record audits to ensure documentation is consistent with billing.
  13. Oversees claim submission to third-party payers; Processes and posts payments from payers.
  14. Prepares daily batches for upload and posting and performs daily reconciliation to ensure all claims and payments are submitted and posted.
  15. Monitors charges for correct payment of claims and capitation deductions.
  16. Researches and resolves claim, payment, and capitation problems.
  17. Processes paper claims, including secondary insurance as necessary.
  18. Prepares, reviews, and sends patient statements.
  19. Participates in educational activities to stay current on industry updates and attends weekly/monthly staff meetings.
  20. Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
  21. Other duties as assigned.

Qualifications:

  1. High school diploma or equivalent.  Associate degree preferred.
  2. Three (3) to Five (5) years’ experience in medical billing practices, CPT/ICD codes and modifiers, and medical terminology.
  3. Good organizational skills and attention to detail to simultaneously handle a variety of tasks effectively.
  4. Strong written and verbal communication.
  5. Excellent numerical and analytical skills.
  6. Ability to work and communicate effectively and clearly with patients, staff, and others.
  7. Ability to develop and maintain courteous, effective working relationships with patients, staff, and others.
  8. Ability to work independently, as well as part of a professional team.
  9. Knowledge of clinic policies and procedures.
  10. Knowledge of health care insurance claim practices and compliance.
  11. Knowledge of computer systems, programs, and applications; working knowledge of Microsoft Excel and other Office products.
  12. Ability to maintain the highest level of confidentiality when dealing with patient records and personal information.
  13. Bi-lingual in Spanish/English preferred

To learn more about our organization, please visit our website at www.mnhc.org. We offer a full range of benefits which includes the following:

  • Medical Insurance – MNHC pays 90-100% based on plan
  • Dental and Vision Insurance – free to employee
  • Life Insurance – free basic policy plus voluntary option
  • Flexible Spending Accounts for health & dependent care expenses
  • Commuter benefits for public transportation expenses
  • Vacation – 2 weeks (3 weeks after 5 yrs; 4 weeks after 8 yrs)
  • 12 Paid Holidays plus your birthday and 12 Sick Days each year
  • 40 hours Paid Educational Leave
  • 401k Retirement Savings Plan with Company Contribution

Mission Neighborhood Health Center is an Equal Employment Opportunity employer committed to fostering an inclusive environment for our diverse workforce. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, reproductive health decisions, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, genetic information, or other applicable legally protected characteristics. Pursuant to the San Francisco Fair Chance Ordinance, we will consider employment for qualified applicants with arrest and conviction records.

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