Healthcare Billing Specialist

1 week ago

Garden Grove, California, United States Titanium Healthcare Full time
Job Overview

Salary: $21 - $25 per hour DOE

Position Summary: Titanium Healthcare is in search of a dedicated Billing Specialist to enhance our vibrant and expanding team. This role involves the meticulous posting, assessment, and invoicing of claims as well as managing outstanding accounts receivable within our electronic health records (EHR) system. The successful candidate will ensure the integrity of EHR data as it pertains to accounts receivable, while also performing essential data entry and billing functions. Additionally, the specialist will guarantee that all information is processed accurately, payments are recorded, and any denials are addressed promptly.

Key Responsibilities:

  • Identify and communicate denial trends and issues to internal team members, collaborating effectively with management to resolve these matters swiftly.
  • Evaluate patient accounts, addressing insurance and patient payment discrepancies, and clearly communicate the reasons for any outstanding balances to patients.
  • Manage and resolve complex denied and voided claims, ensuring follow-through until claims are successfully paid.
  • Maximize reimbursement for services rendered.
  • Prepare and submit billing data and medical claims to insurance providers, including 837 and 1500 claims.
  • Monitor and document payment plans for patient statements.
  • Proactively assess, research, and resolve billing issues creatively and flexibly.
  • Organize and prioritize multiple tasks to meet both internal and external deadlines.
  • Accurately post payments to accounts in a timely manner.
  • Collaborate with the revenue cycle manager and operational leadership to address frequent issues and develop solutions to prevent future errors.
  • Conduct bi-monthly eligibility checks for clients and compile reports for management regarding terminated Medi-Cal clients as necessary.
  • Establish a tracking system for claims and health plans being worked on.
  • Respond to inquiries and communications promptly, typically within 24-48 hours.
  • Assist in developing and reviewing billing procedures to ensure compliance with local, state, and federal regulations.
  • Perform additional duties and projects as assigned.

Qualifications:

  • Education: A minimum of a high school diploma is required; an associate degree in a medical field is preferred.
  • Experience: At least 3 years of experience in clinical accounts receivable, practice management, or medical administration is required.
  • Language: Proficiency in English (both written and verbal) is required; bilingual in Spanish is preferred.
  • Required Skills:
    • Ability to understand and become proficient in medical billing software.
    • Familiarity with Medi-Cal, Medicare, commercial, and patient statement billing.
    • Proficient in Microsoft Outlook and related applications.
    • Detail-oriented with a strong focus on accuracy and thoroughness.
    • Demonstrated initiative and sound judgment in decision-making across varied situations.
    • Experience with EHR systems is essential.
    • Strong multitasking and prioritization skills to complete projects effectively.
    • Ability to work independently and maintain excellent organizational skills.
    • Preferred experience with primary care and Medi-Cal billing.
    • Experience with EClinicalWorks is advantageous.

Physical Requirements: This position requires the ability to perform office work and travel as needed, including:

  • Consistent operation of a computer and other office equipment.
  • Remaining stationary for up to 75% of the time.
  • Mobility around the office for up to 50% of the time.
  • Occasional lifting or carrying of office equipment weighing up to 15 pounds.
  • Ability to operate a vehicle for meetings and office visits as required.

Benefits:

  • This role offers a hybrid work environment, allowing for both remote work and in-person member service.
  • Comprehensive Medical, Dental, and Vision Insurance.
  • Coverage of up to 100% of your premium and 50% of dependent premiums, depending on the plan.
  • Access to Flexible Spending Accounts, Health Savings Accounts, and Dependent Care Accounts.
  • Life, AD&D, and Short-Term Disability Insurance fully funded by Titanium Healthcare.
  • 401(k) plan available.
  • Employee Assistance Program.
  • 11 Paid Holidays and 3 weeks of all-inclusive PTO per year, with accrual beginning on the first day of employment, in addition to a separate Paid Sick Time balance.

Equal Employment Opportunity Commission:
Titanium Healthcare is committed to transforming healthcare to reduce costs and improve outcomes, providing compassionate and coordinated care to all. We believe that achieving this mission begins with a diverse and inclusive workforce.

We are an equal opportunity employer, encouraging applicants from all backgrounds to apply. Diversity and inclusion are essential to our innovation and equity in healthcare, enabling us to better serve our communities.

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