Billing Representative II

About the role

As a Billing Representative II, you will be responsible for billing claims and addressing denials on behalf of Primary Health Care, Inc. Responsible for completing work queues as well as daily, weekly, and monthly tasks related to the full billing cycle. Ensures compliance with all State, Federal, and third-party payer requirements regarding confidentiality and billing. Responds promptly to billing or patient account inquiries. Demonstrates PHC's iCare values in daily work.

What's Great About this Position?

• Earn 4 weeks of PTO throughout your first year of employment and enjoy paid holidays as well
• Continue to develop your skills and grow your career through PHC's training opportunities including: PHC University, Emerging Leaders, and medical and dental assistant training programs

Responsibilities

• Accurately bills claims for medical, dental, and hospital services provided by PHC
• Updates patient charts with new or updated information and completes any associated back-billing
• Addresses denials and rebills claims to maximize revenue for the organization
• Completes daily entry of inpatient demographics, ICD10 and HCPCS codes, and charges into EHR; ensures inpatient claims are completed by providers, and follows up as necessary on missing charge tickets
• Works collaboratively with OCHIN Billing Services representatives, responding promptly to work queues and inquiries on accounts by patients or third-party payors
• Ensures compliance with all State and Federal patient financial service requirements, including, but not limited to, patient rights, confidentiality, and third-party billing
• Supports Billing Representative I in responding to inquiries on patient accounts
• Performs other duties as assigned

Required Qualifications

• Associate degree. Equivalent experience may be considered in lieu of the required education
• At least 2 years of experience in healthcare billing and use healthcare billing software or a related field
• Experience working with CDT/CPT codes for all dental/medical insurance carriers
• Experience working with CDT/CPT and ICD-10-CM coding related to managed care programs and dental/medical billing requirements
• Experience working with dental/medical insurance contractual agreements, Medicare and Medicaid regulations, payment, and recoupments

Required Skills

• Reading and analysis skills with the ability to interpret remittance advice with remark codes and denial information
• Strong technical knowledge and expertise
• Excellent written and verbal communication skills
• Exceptional interpersonal and customer service skills
• Training and facilitation skills
• Advanced computer proficiency, including use of email, word processing, and spreadsheet applications

Preferred Qualifications and Skills

• Experience using Epic software as well as medical practice management software for a billing office
• Experience in all aspects of billing within both a clinical and hospital setting
• Experience in a Community Health Center/FQHC
• Supervisory skills
• Proficiency in computerized patient accounting applications
• Medical Billing Certificate, Certified Professional Coder preferred
• Fluency in spoken English and Spanish, with the ability to communicate clearly and accurately in both languages

Pay

Your experience and skills determine your base pay. The hiring range for this position is typically $18.65 - $23.32 per hour. Candidates with extensive work experience related to this position may be considered for additional compensation up to the pay grade maximum of $27.98 per hour.

Benefits

• Generous PTO accrual (equal to 4 weeks at end of 1st year) plus paid holidays
• License/certification fee reimbursement
• Paid time off for continuing education & continuing education reimbursement
• Tuition reimbursement program
• 401k with company match
• Medical, dental, and vision insurance
• Life & disability insurance
• Flexible spending & health savings accounts
• Supplemental accident & critical illness insurance
• Discounts on pet insurance