Billing Specialist

3 weeks ago

San Bernardino, United States Sac Health Full time

**Who We Are**:
SAC Health empowers our patients and their families to live vibrant and healthy lives through culturally responsive, exceptional care. Patient-centered, whole-person care. Our unique, full scope, team-based approach is what makes SAC Health the provider of choice for patients.

Top-Tier Patient Satisfaction Scores | Largest Teaching Health Center FQHC | 11 Locations offering 44 Specialties | NCQA Patient-Centered Medical Home Level 3 Certified
Multi-Site Approved for NHSC & NCLRP loan forgiveness programs - **NHSC/Nurse Corps/STAR/Pediatric Specialty | HPSA Scores**: Primary: 17 | Dental: 25 | Mental: 20

**What We Are Looking For**

The Billing Specialist assumes the responsibility of receiving and sorting incoming payments with attention to credibility. Manage the status of accounts and balances and identify inconsistencies. Issue and post bills, receipts, and invoices. Perform all patient billing functions including but not limited to charge posting, claim preparation, claim review, and claim submission to patients and all third-party payers either by paper or electronically. Check the validity of debit accounts, and update accounts receivable database with new accounts or missed payments. Write thorough reports on billing activity with clear and reliable data.

**_ Schedule_**_: 4 days per week, 10 hours per day, Monday - Thursday _**_|_**_ _**_Location_**_: Norton Clinic, San Bernardino, CA_

**ESSENTIAL FUNCTIONS AND DELIVERABLES**
- Perform all patient billing functions, including but not limited to charge posting, claim preparation, claim review, and claim submission to patients and all third-party payers either by paper or electronically.
- Consult with patients regarding insurance eligibility and benefits, financial policy, and account status as needed. Identify and resolve patient billing complaints.
- Answer the telephone and follow up on the caller's request and STAT requests.
- Bill all payers including but not limited to Medi-Cal, government programs, private and Medicare for services at SAC Health. Answer all insurance inquiries.
- Perform EOB/Denial management daily and or weekly to maintain all denials' current and up-to-date status. Correct and submit claims for re-bill to insurance carriers weekly.
- Post payment (electronically and manually) and process all payments to patients and insurance companies where overpayments have occurred.
- Perform electronic billing processing/batch submission daily, review all claims rejected by the clearinghouse, correct claims, and resubmit the claims daily.
- Perform all patient collection functions, including but not limited to calling patients, notifying patients of delinquent accounts via mail and phone, and discussing payment plan options.
- Track daily encounters as requested. Discuss with medical assistants and providers regarding missing encounters as requested.
- Answer all patient account inquiries made by patients and payers. Utilize computer and EMR to run print-outs for follow-up on claim status, claims or fee tickets to be billed, and audit reports as needed. File billing documents as directed by the departmental processes.
- Must demonstrate strong critical thinking skills, take initiative, be self-motivated, and perform thorough research in order to accomplish day-to-day tasks.
- Maintain the strictest confidentiality, and adhere to all HIPPA guidelines and regulations.
- Assist in handling complex patient issues. May be called upon to assist the Supervisor/Manager/Director to intervene in difficult or sensitive matters.
- Other duties as outlined in the official job description.

**QUALIFICATIONS**:

- Education: High School diploma or equivalent required. Additional studies in business are preferred. Medical Terminology knowledge preferred.
- Licensure/Certification: As a requirement of this position you must receive EPIC certification for the module you have been hired
into.
- Experience: 3+ years or more of billing or equivalent experience required. Healthcare billing preferred.
- Essential Technical/Motor Skills: Input data, speaking clearly, handling/gripping charts and papers; digital dexterity. Familiar with use of telephone, fax machine and proficient of computer. Must have pleasant and courteous telephone voice manners. Must be knowledgeable in many types of office equipment. Bilingual fluent in English and Spanish preferred.
- Interpersonal Skills: Strong public relations and communication skills in dealing with patients and their families. Communicate well with medical staff, outside agencies, public and co-workers. Ability to maintain a professional attitude in difficult situations and communicate effectively. Understand needs of clinic and is a team player.
- Essential Mental Abilities: Critical thinking skills and attention to detail. Must be able to be flexible to variety of tasks and be well organized. Must be able to handle multiple telephone line ringing simultaneously. Must be able to prioritize work w

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