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Medical Billing Specialist I

2 months ago

Escondido, California, United States Neighborhood Healthcare Full time
Job Overview

At Neighborhood Healthcare, we are dedicated to fostering a community where individuals thrive through access to quality health services. Our commitment extends beyond basic healthcare; we aim to empower our patients with the resources they need to lead fulfilling lives. Since our inception in 1969, we have prioritized compassion, integrity, and collaboration in every role.

The **Insurance Biller I** plays a crucial role in advancing the mission of Neighborhood Healthcare by managing the medical billing process for patients and various funding sources. This position ensures adherence to coding standards and compliance with contractual obligations and funding programs.

Key Responsibilities

  • Analyze clinical documentation to gather payer requirements for accurate claim submissions.
  • Identify and rectify missing information in billing submissions, including diagnosis and procedure codes.
  • Prepare and submit claims for billable services, ensuring compliance with industry standards.
  • Monitor claim statuses to guarantee all transactions are accounted for during financial close periods.
  • Assist patients with registration in the payment portal as necessary.
  • Verify patient eligibility and ensure completeness of information, including authorization numbers.
  • Apply discounts for eligible patients under the Sliding Fee Discount Program.
  • Record patient and insurance payments accurately, adjusting account balances as required.
  • Process refunds and manage insurance recoupment requests efficiently.
  • Generate patient statements for cash accounts when necessary.
  • Coordinate monthly collections with external agencies as needed.
  • Support patient inquiries via phone and respond to voicemails promptly.
  • Address billing questions from patients to resolve issues effectively.
  • Facilitate payment plan negotiations with patients when appropriate.
  • Deliver exceptional customer service and escalate complex issues to management as needed.
  • Respond to correspondence from sites, insurers, and patients regarding billing in a timely manner.
  • Participate in training sessions and team meetings to enhance billing knowledge.

Qualifications

Education and Experience:

  • High school diploma or GED is required.
  • Certification in medical billing or coding from an accredited institution is preferred.
  • A minimum of two years of experience in front office or medical administration is required; experience in medical billing is preferred.
  • Experience in a specialty or Federally Qualified Health Center (FQHC) is a plus.

Skills and Abilities

  • Strong verbal and written communication skills, with proficiency in composition and proofreading.
  • Ability to interpret various forms of instructions effectively.
  • Familiarity with insurance eligibility processes and coverage guidelines across multiple carriers.
  • Knowledge of billing compliance standards and coding systems (CPT, HCPCS, ICD).
  • Understanding of insurance payers, funding sources, and managed care frameworks.
  • Capacity to manage multiple tasks efficiently.
  • Excellent organizational and planning skills.
  • Ability to work collaboratively within a team and independently.
  • Proficiency in handling confidential information with professionalism and ethics.

Compensation: $29.75 per hour, commensurate with experience.