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Billing and Coding Specialist
2 months ago
At Apicha Community Health Center, our goal is to enhance the health of our community by providing comprehensive primary care, preventive health services, mental health support, and additional services tailored to our diverse population.
We are dedicated to delivering high-quality, culturally sensitive care to underserved groups, particularly focusing on Asians, Pacific Islanders, the LGBT community, and individuals impacted by HIV/AIDS.
Role Summary:
We are looking for a Revenue Cycle Associate to join our team. This role is pivotal in ensuring accurate billing processes and managing patient accounts under the guidance of the Revenue Cycle and Patient Account Director.
Key Responsibilities:
- Oversee and reconcile billing encounters, including claim and statement processing.
- Conduct corrective coding and payment posting.
- Manage accounts receivable and follow up on denials.
- Prepare, review, and transmit 827P/837I claims for Institutional (UB04), Professional (HCFA), and Dental (ADA) billing.
- Print and submit paper claims promptly.
- Investigate and resolve unpaid, rejected, and denied claims.
- Communicate with insurance carriers to facilitate claims resolution.
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. Experience in a Federally Qualified Health Center (FQHC) or Community Health Center (CHC) setting is preferred.
Familiarity with Medicaid, Medicare, and various insurance guidelines, including Commercial, Managed Care, Advantage, HMO, and PPO, is essential.
Knowledge of facility-based billing methodologies, revenue rates, and relevant regulations is advantageous.
Experience in multi-specialty environments such as Dental, Family Health, Infectious Disease, Pediatrics, Women's Health, and Mental Health is beneficial.
Proficiency in Medical Billing Systems and Electronic Health Records, such as eClinicalWorks, EPIC, or Medisoft, is required. A solid understanding of CPT4 and ICD10 coding is also necessary.
Skills:
Strong interpersonal and communication skills are vital, enabling effective interaction with diverse physician practices and their patients. Proficiency in Microsoft Office applications, particularly Excel, Outlook, and Word, is also required.
Physical Requirements:
The role may involve extended periods of standing, walking, or sitting. Candidates should have the ability to hear and see within normal ranges and possess strong verbal and written communication skills. Reasonable accommodations may be made to assist individuals with disabilities in performing essential job functions.
