Under the direction of the Revenue Cycle Manager, the Billing Specialist will be responsible for accurate and timely billing processes, including preparing and submitting claims, resolving denials, and ensuring compliance with FQHC regulations, while also assisting patients with billing inquiries. The Billing Specialist will understand and model the mission of Bond CHC. Successful performance of job duties will directly impact health system goals to obtain appropriate reimbursement and compensation for services rendered by professional staff. The Billing Specialist will ensure and maintain all records in compliance with HIPAA.
DUTIES AND RESPONSIBILITIES:
1. Process daily the medical and dental billing for Bond CHC patients.
2. Timely follow up on insurance claim denials, exceptions or exclusions.
3. Ensure compliance with all regulatory requirements related to FQHC billing.
4. Work with various third-party payers to resolve billing issues.
5. Respond to inquiries from insurance companies, patients and providers.
6. Ensure that all financial documents received by patients during collection activities are appropriately scanned in patient accounts.
7. Coordinate with the Revenue Cycle Manager on any back billing and/or account adjustments necessary due to financial documentation presented by patients during collection activities.
8. Actively participate in internal quality improvement teams. Works with members proactively to support quality improvement initiatives in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards.
9. Do other duties as assigned.
QUALIFICATIONS
- A high school graduate or equivalent.
- At least one year experience in a medical health care organization performing medical or dental billing activities or working with patient accounts.
- Ability to operate a computer including internet for accessing insurance plan web portals.
- Well organized, friendly, courteous, adaptable, dependable and patient. Must have ability to work well under pressure and be an effective communicator.
- A high degree of maintaining confidentiality.
- Clerical experience with ability to compose letters, contact patients and other professional organizations by telephone in a manner representing the organization’s mission and goals.
- Prerequisites for the positions generally include a clean criminal background check and drug test.