Certified Medical Billing and Collections Specialist (Bilingual Spanish)

Description

POSITION TITLE: Certified Medical Billing and Collections Specialist

LOCATION: HOPE Health and Wellness Center

REPORTS TO: Medical Billing and Collection Specialist Team Lead

EDUCATION: High School Diploma or equivalent required, associate degree preferred; Certified Medical Coding/Billing required.  

WORK EXPERIENCE: 1 year of applicable CPC/CSS billing experience or graduated from a Medical Billing program within the last two years with the completion of 180 externship hours; willing to get coding certification within a year of employment.

SALARY RANGE: $20 - $25/Hour DOE

FLSA STATUS: Hourly - Non-exempt

POSITION TYPE: Full-time

LANGUAGE: Bilingual preferred

HOPE Clinic provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

JOB SUMMARY:

The medical billing and collection specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers. The medical billing and collection specialist must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments base on payer contracts or government regulations. In addition, the medical billing and collection specialist must demonstrate proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claims. 

MAJOR DUTIES & RESPONSIBILITIES:   

• Responsible for charge and payment entry within Electronic Health Record. Coordinates and clarifies with providers, when necessary, on information that seems incomplete or is lacking for proper account/claim adjudication.
• Responsible for correcting, completing, and processing claims for all payer codes;
• Analyze and interpret that claim are accurately sent to insurance companies; 
• Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports;
• Process appeals online or via paper submission.
• Assist in reconciling deposit and patient collections;
• Assist with billing audit related information;
• Process refund requests;
• Attend provider meetings/ workshops when needed;
• Communicate with billing and credentialing coordinator to identify and resolve audit review issues;
• Process billing calls and questions from patients and third party carriers;
• Answer/respond to correspondence related to patient accounts. Is available to answer billing and changes related inquiries by patients, staffs, Managed Care Organization, etc.;
• Communicate daily with internal and external customers via phone calls and written communications;
• Identify trends, and carrier issues relating to billing and reimbursements. Report findings to Team Lead and/or Supervisor;
• Research, record findings, and communicates effectively with Manager to achieve optimum performance;
• Pursue and participate in education to remain current with changes in the Healthcare industry;
• Maintain patient confidence and protects medical office operations by keeping patient information confidential;
• Contribute to team effort by accomplishing related results as needed;
• Promote effective working relations and work effectively as part of a team to facilitate the department’s ability to meet its goals and objectives;
• Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to insure a professional, responsible and courteous environment;
• Attend on-site/off-site community engagement activities and on-site/off-site clinic events as needed; 
• Perform other duties as assigned to support HOPE Clinic’s Mission, Vision, and Values. 

Requirements

QUALIFICATION REQUIREMENTS:

• Minimum of 6 months of related experience in a business, medical or technical environment
• Previous experience in a medical office setting and/or experience with an Electronic Medical Record a plus,