Billing Specialist II
Job Description
Pay Rate: $23-$24.15/hr
Benefits: Health, Dental, Vision, PTO, 401K
Location: Stockton, CA
Schedule: M-F, 8am to 5pm
Requirements of the Medical Billing Specialist:
- High school graduate or possession of a GED and three years of experience?OR?AA degree and one year of experience. Experience required should be focused on progressive billing experience in a clinic or hospital setting.
- Federally Qualified Health Center experience is preferred.
- Billing certificate is preferred.
- Knowledge and experience utilizing medical terminology, ICD-10 CM, HCPCS and applying CPT coding rules
- Ability to use 10-key, ability to type 45 wpm
- Experience and knowledge of computerized medical or dental billing systems
Responsibilities of the Medical Billing Specialist:
- Responsible for maintaining the clinic billing of all patients to include charges, payments, adjustments, and any follow-up necessary for Self-Pay, Medi-Cal, Medicare, and third-party payers.
- Reviews patient chart documentation to assure correct coding and accurate billing.?
- Analyzing patient medical records to determine billable services based on payer. guidelines that include Medi-Cal, Medicare, Commercial, and State Specialty Programs.?
- Evaluate the accuracy of pending charges including dates of service, procedure, location, ICD-10 CM, CPT, CPT II, CDT, HCPCS Codes and modifiers.
- Ensure timely and accurate charge submission through electronic EHR charge capture.
- Review first initial claim scrub before billing utilizing the practice management software.
- Importing of Electronic payments from third party payers that include Medi-Cal, Medicare, Commercial, and State Specialty Programs.?
- Perform quality control of data entry to verify proper balancing/posting of payments to claims with accuracy and timeliness.
- Runs reports that require monitoring of unpaid claims with the appropriate payer in an effort to collect outstanding claims.
- ?Ability to research, analyze, and identify billing errors in detail quickly and independently and follow-up by rebilling denied and rejected claims in a quick and on a timely manner.
- Actively participates in conversations with Revenue Cycle Director or designee to discuss any billing challenges.
- Verifying eligibility for third party payers that include Medi-Cal, Medicare, Commercial, and State Specialty Programs.
- Independently performs follow-up procedures as necessary for all third-party payers including Medi-Cal Medicare, and self- pay patients’ questions.
- Writes off credit balances as appropriate.
- Compares insurance files with family insurance files to determine appropriateness of out-of-balance.
- Provides requested information for patient subpoenas.
- Collaborate closely with Center Managers, clinical support staff, and providers with pending charge acceptance corrections.
- Answer billing and charge related inquires by patients, staff, and third-party payers.
- Runs various types of reports as needed.
- Performs other duties as assigned.
Meet Your Recruiter
Candace Abell
Sr. Staffing Consultant
Born and raised in Fresno, Candace has been a Central Valley girl from the start. She attended Fresno State University and was a member of Kappa Kappa Gamma Sorority. After relocating to Modesto, Candace started her family and her career in health care staffing. Candace knew almost instantly that she had found her calling- finding the right person for the perfect practice! Candace has been a pillar in the AVAILABILITY office since 2007. She leads the healthcare services placement division and brings over 30 years experience in health care placement. When Candace isn’t finding “just what the doctor ordered” she is visiting and enjoying her 5 grandchildren, gardening, wine tasting, walking, listening to music and just being with family and friends.