Billing Specialist Lead
2 weeks ago
La Clinica de La Raza is a community-based health center dedicated to providing high-quality, culturally appropriate healthcare to the diverse communities of the San Francisco Bay Area. With over 40 years of experience, we have established ourselves as a leader in healthcare activism, advocating for and creating a health home for those who have been denied access to care.
About the Position
The Billing Specialist Lead is a critical role within our Business Office, responsible for the processing and submission of clean, accurate claims to third-party payers on behalf of La Clinica. Key areas of responsibility include:
1. Escalating items identified missing information on claims with clinicians to provide accurate, missing information (quantities, codes, etc.) to billers.
2. Understanding of various managed care contracts in place (for each servicing county), to assist with determining if claims were adjudicated properly.
3. Providing excellent customer service while interacting with team, internal and external customers while resolving issues.
4. Discussing matters with the Director as they occur related to day-to-day operations of the Business Office.
5. Attending department meetings and trainings as directed.
6. Additional duties as assigned.
Requirements and Knowledge
The ideal candidate will have:
1. Demonstrated knowledge and experience with third-party reimbursement programs, and the ability to identify problems with payers (e.g., Medicare, Medi-Cal, and other third-party carriers).
2. ICD-10, CPT Code, and A/R knowledge.
3. Ability to explain and apply billing policies and procedures for various programs.
4. Proficiency with Microsoft Word and Excel.
5. Thorough knowledge of working within an EPM/EMR (electronic medical record system).
Preferred Qualifications
The preferred candidate will have 3-5 years of experience in a medical environment performing billing or medical accounts receivables functions, with previous FQHC experience preferred but not required. Experience with billing and collection practices is also essential.
What We Offer
La Clinica de La Raza offers a dynamic and supportive work environment, with opportunities for professional growth and development. We are committed to fostering a culture of diversity, equity, and inclusion, and we welcome applications from candidates who share our values.
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