Salud Para La Gente (SALUD) provides high quality, comprehensive and cost-effective medical, dental, behavioral health, optometry and other services to underserved, low-income communities in the Monterey Bay area, including Santa Cruz and Monterey Counties. SALUD began in Watsonville in 1978 as a storefront free clinic, and is now a Federally Qualified Health Center. With 4 health center sites, school-based health centers and over 400 employees, we provide high quality services to patients of all ages.
We are seeking an experienced, Accounts Receivable Specialist to provide financial, clerical and administrative services to ensure efficient, timely and accurate payment of accounts. Under the supervision of the Billing-Accounts Receivable Supervisor, the Accounts Receivable Specialist will be responsible for processing all payments from state programs and health insurance agencies. Accounts Receivable Specialist will also be responsible for managing refunds and credits, as well as assisting with additional confidential agency financials.
Responsibilities include, but are not limited to, the following:
- Processes all assigned account receivables.
- Reviews all copies of checks received and deposits for appropriate payment allocation.
- Maintains insurance EOB’s and remittance advice files up-to-date.
- Applies all patient revenue payments received in the practice management system using the proper payment source.
- Assigns appropriate denial codes to claims denied in the practice management system.
- Ensures that all payments and denials are entered in the practice management system on a timely manner within policy procedures.
- Maintains deposit reconciliation journal on a daily basis to ensure proper reconciliation of deposits.
- Analyzes current flow and provides suggestions for workflow improvement.
- Communicates to Controller of incoming state revenue.
- Prepares and reconciles all monthly reconciliation reports; submits to Controller at the end of each month.
- While entering payments, works in coordination with the billing department to identify unpaid claims.
- Identifies and submits refunds to patients and insurance companies for proper recoupment process.
- Logs and reports payment withholds.
- Reviews all credit balances and makes necessary allocations based on payer source.
- Identifies and reports payer rate changes and inconsistencies in payments based on policy and procedures.
- Reviews all returned patient financial correspondence and coordinates address correction.
- Assists in preparing reports for the financial audits.
- Works in coordination with billing department with any claim payment and EOB related issues.
- Provides necessary EOB files to billing department for proper claim submission.
- In coordination with Data Systems, maintains electronic ERA and EFT set up up-to-date with payers.
- Assists with confidential agency financials utilizing a high level of discretion.
- Ensures a productive work environment and achievement of goals through strategies and practices in line with the CARE fundamentals of communication.
- Consistently adheres to and/or exceed SPLG’s communication guidelines and expectations with internal and external customers including co-workers, patients, and external partners
- Performs other duties as assigned.
The ideal candidate will embrace our mission to provide high quality health care to patients of all ages, This position requires the ability to handle confidential matters with a high level of discretion, process all aspects of accounts receivable with a high degree of accuracy; meet processing deadlines, use basic math accurately; prepare reports; learn policies and procedures; organize work efficiently, using sound independent judgment; think independently and analytically; use a variety of standard office and computer equipment; communicate effectively and respectfully with a diverse group of people, patients and organizations doing business with Salud Para La Gente, demonstrating a knowledge of and sensitivity to their needs; develop and maintain effective working relationships with Salud Para La Gente staff, patients, health insurance agents, government community agency representatives, and the public.
REQUIRED MINIMUM QUALIFICATIONS
- High School Diploma and one year health insurance related accounts receivable experience.
- One year health insurance billing experience.
- Bilingual Spanish/English
- Knowledge of Accounts Receivables cycle (experience preferred).
- One year experience of standard medical coding, CPT and ICD-9.
- Proficient in relevant computer applications (Health related accounting software)
- Must be detail oriented with strong attention to detail
- Valid CA Driver’s License and current vehicle insurance; must be able to travel between sites.
SALARY & BENEFITS
Competitive salary and benefits package.
Benefits include CA Sick Leave and Holiday Pay, prorated per hours worked.
- This position requires full range of body motion, standing, walking, sitting, typing, reaching, bending, moving and/or lifting up to 50 pounds.
** Salud is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Salud is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. To request reasonable accommodation, contact the Salud Human Resources Department, [831-728-8250, and HRDept@splg.org].