Job Summary:

The Billing and Collection Specialist will be responsible for performing a variety of complex billing and collection functions. The duties include but not limited to maintaining and resolving third party billing and collection, reviewing patients’ accounts, verifying eligibility, and reprocessing all outstanding claims for payment. This position will also handle cash transaction and keep all receivables posted on a timely manner while working with others in a team environment.

Duties and Responsibilities:

• Processes charges and submit the statements/claims to the patients and third party insurance. Reassure that the entire claim/statement information is accurate in accordance with all established internal and third-party requirements. Maintain no less than 120 encounters processed per day.
• Generate, filter the claims for errors and submit to the pertaining third party payer.
• Streamlined the Medicare, Medi-Cal, FPACT, CHDP and other third party payer claims for accuracy and initiate claims follow up. Work diligently to reduce the Account Receivables and successfully increase the collection from 80% to 99%.
• Ability to perform under tight deadlines and meet the billing department goals.
• Process all patients ‘cash transaction on the same day that it was received.
• Balance and post all batches on the same day as the process date.
• Prepare encounters reports to account for all visits and follow up on outstanding encounter and supportive documentation.
• Maintain constant and good communication with the clinics ‘administrators and respective staff to resolve encounters and claims issues.
• Report to the Billing Project Coordinator and Supervisor on all billing pressing issues, work status, work flow and claims and payments.
• Abide by the code of ethics and HIPAA regulation guidelines.
• Analyzed and apply payments posting and reversal in accordance with the established billing policies and procedures.
• Evaluate accounts to determinate any corrections for incorrect charges, write-offs and contractual adjustments.
• Ability to perform all other duties as assigned or requested.

Qualifications:

• Billing Degree or Certificate.
• High school diploma or General Education Degree
• At least 2-3 years of billing experience with knowledge on Medicare, Medi-Cal, Denti-Cal and Commercial third party billing.
• Familiar with ICD-10 Coding guidelines.
• Strong interpersonal and communication skills with the ability to work effectively with managers, administrators, clinic’s line staff and vendors. 
• Computer literate, able to use Microsoft Word, Excel and Outlook.

• Strong skills on problem solving and ability to deal with difficult situation in a calm professional manner.

Preferred:

• Bilingual in English and Spanish
• Experience working in a Federal Qualified Health Center setting.

*JWCH requires employees to be vaccinated with exceptions only as required by law (i.e. medical or religion).
Employee Benefits: JWCH Institute, Inc., offers competitive salaries for all positions. Employees working 30 hours per week or more are provided a monthly allowance which can be used towards medical, dental, vision, and life insurance premiums. The agency offers sick leave and vacation accrual, 11 paid holidays, jury duty pay, mileage reimbursement, employee parking, direct deposit, credit union, and an employee assistance program. In addition JWCH offers a 401(k) Profit Sharing plan to employees who work a minimum of 1,000 hours per fiscal year.Wesley Health Centers, JWCH Institute is an equal opportunity employer.