Medical Claims Biller/Receptionist

Position Title: Medical Claims Biller/Receptionist

Department: Colusa Indian Health Clinic

Reports to: Director of Clinic Operations

Classification: Non-Exempt

Position Status: Regular, Full Time

THE POSITION:

The Medical Claims Biller/Receptionist is responsible for maintenance of patient accounting systems and the day-to-day delivery of billing support services that support the delivery of patient-focused care.

The incumbent is expected to work in accordance with the mission, purpose, and values of the Colusa Indian Community Council.

The current vacancy is for a bilingual-Spanish position.

ESSENTIAL DUTIES and RESPONSIBILITIES:

To perform this job successfully, the incumbent must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable incumbents with disabilities to perform the essential functions of the job.

• Responsible for posting all patient charges and providing guidance in charge posting to other staff as appropriate;
• Generate monthly billing statements to third party payers and patients;
• Billing of Medi-Cal and Medicare for patient services covered under specific contracts;
• Respond to patients and third party payers who have questions about their billing statements;
• Managing AR aging, including, but not limited to, managing processes for collections of outstanding receivables, including mailing statements and follow up for outstanding patient balances;
• Provide guidance to front reception staff on how to pre-verify eligibility, interpret benefits, collect co-pays and deductibles and generate route slips;
• Prepare daily/weekly deposits and submit to accounting department;
• Audit and process accounts payable requests;
• Generate monthly reports as requested by Administrator and Accounting Department;
• Provide additional support to accounting department, such as account reconciliations, month end and year end close, and other general accounting duties as required;
• Work closely with additional billing staff, assisting as requested with special projects;
• Assist Director of Clinic Operations with special projects as assigned;
• Collaborate with all coworkers in performing duties required to provide patient-focused services that meet all regulatory and licensing standards;
• Answer telephones courteously, make appointments and take messages according to protocols;
• Greet patients and visitors warmly at the front desk and provide both registration and exit support services;
• Document insurance eligibility and inform patients of the estimated services cost and their treatment plan payment requirements;
• Prepare clinical records for patients’ visit with the provider;
• Balance daily cash receipts and cash bag;
• Assist clinical staff in maintenance and filing of completed patient dental records;
• Performs medical interpretation/translation for patients and their families, including in-group setting, such as family conferences;
• Make notations in the patient's chart indicating the origin of the request for interpretation or translation, the nature of the service provided (such as interpreting treatment orders or pharmacy instructions), and an assessment of the patient's understanding and level of acceptance of the information;
• Translates correspondence, medical histories, medical consent forms, medical procedures and instructions, legal documents, manuals, brochures and other pertinent documents as necessary;
• May perform other duties commensurate with the functions and level of the position.

MINIMUM QUALIFICATIONS:

• Education: Certified biller and/or certified coder helpful, but not required. High school graduate.
• Experience: At least three (3) years of experience working in a dental and/or medical office setting. Related education may be substituted for experience.
• Licensing and Other Qualifications:
• Must be at least eighteen (18) years of age.
• Bi-lingual in Spanish.

ADDITIONAL DESIRED QUALIFICATIONS:

• Experience in billing Medi-Cal and Medicare as an FQHC (Federally Qualified Health Center) required.
• Solid understanding of medical and dental insurances, co-pays, deductibles.
• Experience with EDI method for billing (NextGen preferred).
• Experience using modifiers, occurrence codes, value codes, revenue codes, etc. is required.
• Strong computer skills, including Microsoft Office (e.g., Excel, Word) is required.
• Strong written and verbal communication skills.

SUPERVISORIAL DUTIES: None

ADDITIONAL KNOWLEDGE, SKILLS, and ABILITIES:

• Thorough knowledge of computerized accounting systems and procedures;
• Ability to work in a strong team-based environment;
• Ability to work in a fast-paced environment & able to multi-task;
• Flexible and provides assistance to others when needed;
• Dedicated hard worker with ability to report to work on a daily basis.

PHYSICAL REQUIREMENTS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee:

• Will be required to sit for extended periods of time.
• May be required to stoop, bend, reach or kneel.
• May occasionally lift and/or move up to 25-50 pounds.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• Work is performed in an office setting which is well-lit, ventilated, and temperature controlled.
• The noise level is usually low to moderate.
• The incumbent routinely uses standard office equipment such as computers, telephones, photocopiers, and fax machines.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• billing and/or coding: 3 years (Preferred)

Language:

• Spanish (Required)

License/Certification:

• certified biller and/or certified coder certification (Preferred)

Work Location: In person