Billing Clerk in San Juan Capistrano, California at Mission Hospital Camino Health Center

Job Summary

Primary job function is to work as part of the patient care team in providing high quality, efficient and service oriented patient care demonstrating the health center’s core values. Under the direct supervision of the Revenue Cycle Manager, the Billing Clerk is responsible for capturing all medical, behavioral health, and dental clinic encounters; submitting claims associated with the billable programs and for reconciling those claims with the program’s explanations of benefits. The Billing Clerk is charged with supporting health center staff in appropriately educating and referring patients to wellness, health care and financial assistance resources. The Billing Clerk is responsible with performing various administrative duties in support of Camino Health Center’s Management Team and Patient Services Representatives.

Billing

• Ensures that all encounters are complete and accurately captured in the practice management system within established time frame.
• Ensures proper coding of diagnosis, procedures, and services per applicable third party requirements.
• Reviews charge history for each visit.
• Makes sure that all patient demographic and insurance information is captured and entered accurately.
• Responsible for accurate completion of insurance verification for all visits.
• Accurately prepare all claims for submission.
• Completes timely submission of all claims utilizing electronic and manual billing processes for all revenue sources.
• Ensures all month-end close deadlines are met.
• Reviews and correct edited claims/denials and re-bill or re-submit for payment.
• Responsible for accurately posting all billing activity into the health center’s practice management system.

Administrative Support

• Provides coverage for billing phone lines

Additional Responsibilities

• Performs other duties as assigned by supervisor

Knowledge / Skills / Abilities

• Work collaboratively with people of all ages, social, and ethnic backgrounds
• Work independently and as part of a team
• Basic time management skills with the ability to simultaneously manage multiple tasks and meet deadlines
• Strong organizational skills
• Ability to work in a fast passed environment
• Basic oral and written communication; basic math skills
• Proficient in using computer and office equipment
• Ability to convey a sense of confidence and trust to all patients
• Ability to relate well to other health professionals and support staff
• Ability to carry out administrative and patient support services and consultative responsibilities as required
• Ability to maintain patient confidentiality

Information Management

• Treats all information and data within the scope of the position with appropriate confidentiality and security

Risk Management

• Cooperates fully in all risk management activities and investigations

Safety Requirements

• Knowledge of, observes, and complies with clinic safety policies and emergency procedures

Additional Requirements

• Assertive communication style and ability to work independently with diverse client base
• Able to work flexible hours, including evenings and weekends
• Able to work at various health center locations and outreach sites

Minimum Position Qualifications

• Education: High School graduate or equivalent
• Experience / Training: Bilingual English/Spanish; strong interpersonal communication skills; knowledge of medical terminology including ICD-10 coding

Preferred Position Qualifications

• Experience / Training: FQHC billing experience and experience using a practice management system
• License / Certification: Medical billing and coding certificate

Environmental Conditions

• This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Position involves sitting for extended periods of time while working at a computer. Positions in this job family typically work in an office setting but may be assigned more physical duties such as transporting office supplies and equipment.

Physical and Personal requirements

• Must have reliable transportation