Billing and Coding Specialist
2 weeks ago
At Apicha Community Health Center, our goal is to enhance the well-being of our community by providing comprehensive primary care, preventive health services, mental health support, and additional resources.
We are dedicated to delivering high-quality, culturally sensitive services that improve the quality of life for all individuals, particularly those from underserved and vulnerable populations, including Asians, Pacific Islanders, the LGBT community, and individuals affected by HIV/AIDS.
Current Opening: Revenue Cycle Associate
Role Summary:
Under the guidance of the Revenue Cycle and Patient Account Director, the Revenue Cycle Associate plays a crucial role in managing and reconciling billing activities. This includes processing claims and statements, ensuring accurate coding, posting payments, and following up on accounts receivable and denials. Responsibilities also encompass preparing, reviewing, and transmitting claims for Institutional (UB04), Professional (HCFA), and Dental (ADA) billing, as well as managing the timely submission of paper claims. The role requires monitoring, investigating, and resolving issues related to unpaid, rejected, and denied claims, along with initiating and responding to correspondence for claims resolution with insurance providers.
Qualifications and Experience:
Applicants should possess a High School Diploma or GED, along with a minimum of 5 years of experience in Medical and Dental Billing and Coding. Familiarity with billing processes in a Federally Qualified Health Center (FQHC) or Community Health Center (CHC) setting is essential.
Comprehensive knowledge of Medicaid, Medicare, and various insurance guidelines, including Commercial, Managed Care, Advantage, HMO, and PPO, is required.
Understanding of facility-based billing methodologies, including revenue rates and codes, as well as federal, state, and payer-specific regulations, is advantageous.
Experience in multiple specialties such as Dental, Family Health, Infectious Disease, Pediatrics, Women's Health (GYN/Obstetrics), and Mental Health is beneficial.
Proficiency in Medical Billing Systems and Electronic Health Records, such as eClinicalWorks, EPIC, and/or Medisoft, is necessary. A strong command of CPT4 and ICD10 Coding is required.
Exceptional interpersonal and communication skills are vital, enabling effective interaction with diverse physician practices and their patients.
Strong computer skills, particularly in Microsoft Office applications (Excel, Outlook, Word), are essential.
Physical Requirements:
The role demands the ability to stand, walk, or sit for extended periods, with normal hearing and vision capabilities. Strong verbal and written communication skills are essential, along with the ability to work at a computer for prolonged periods in a moderately noisy environment.
Reasonable accommodations may be made to assist individuals with disabilities in performing essential job functions.
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