Billing Tech II

POSITION: Billing Tech II 
DEPARTMENT: Billing
REPORTS TO: Revenue Cycle/Billing Supervisor
LOCATION: Native American Health Center, Inc. (NAHC)
2920 International Blvd., Oakland, CA 94601
WORKING HOURS: Full Time, 40 hours per week, 100% FTE
STATUS: Non-Exempt, Union

POSITION SUMMARY
Billing Tech II Position is responsible for timely and accurate charge entry, collection and the reviewing of payor accounts all NAHC billable service locations. Billing Tech II’s provide training for Billing Tech I’s while working the aging of claims and generating reports. The Billing Tech II is a key member of both the clinic operations and billing department teams.

The Native American Health Center is an accredited facility through the Accreditation Association of Ambulatory Health Care (AAAHC) and the Commission of Dental Accreditation (CODA).

DUTIES & RESPONSIBILITIES
1. Performs daily billing of claims and adjustments to third party insurance according to departmental guidelines and standards. Responsible for communicating with payor on assigned accounts to ensure correct claim is submitted.
2. Ensures that special billing needs by carrier are performed to prevent denial of claims and delay in payment.
3. Apply appropriate co-pay for self-pay invoices.
4. Prepares and submits all final bill claims, secondary claims, rebills and late charges on a daily basis maintaining a current status.
5. Performs routine follow up on unpaid insurance claims. Take appropriate action to resolve problems causing delay in reimbursement.
6. Thoroughly documents all telephone and correspondent communications with third-party payers and guarantors.
7. Prioritizes and works on accounts in assigned work queue to ensure all accounts are submitted in a timely manner.
8. Contacts guarantors and other insured parties when additional information is needed for the insured. Takes appropriate action to resolve any delay in reimbursement.
9. Communicates with providers and department staff to enlist assistance with collection and encounter issues on a daily basis.
10. Review and confirm eligibility as needed to ensure proper payor is listed for each encounter.
11. Ability to access payor websites as needed to process a claim.
12. Provide excellent customer service at all times. Able to answer member questions about their account and resolve issues as appropriate.
13. Responsible for collections on assigned payor accounts.
14. Make appropriate adjustments to processed claims.
15. Fully responsible for communicating with payor on assigned accounts.
16. Works on special projects as assigned.
17. Follows-up and resolves aging accounts with 30+ days.
18. Contacts guarantors and other insured parties when additional information is needed for the insured. Takes appropriate action to resolve any delay in reimbursement.
19. Performs special research or training projects requiring comprehensive understanding of billing procedures.
20. Employee Safety: Safely performs all duties; follows required protective protocols to ensure personal safety as well the safety of others.
21. Must maintain compliance with ergonomic safety standards; be mindful of posture and regularly practice ergonomic stretches.
22. Actively participate in internal quality improvement teams and work with members proactively to drive quality improvement initiatives in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards, when assigned.
23. HIPAA: Keep all protected health information (PHI) confidential and abide by HIPAA policies for the release and disclosure of any PHI. Will report unauthorized use of disclosure of PHI immediately, to supervisor or HIPAA security officer.
24. Work well under pressure, meet multiple and often competing deadlines.
25. At all times demonstrate cooperative behavior with supervisors, subordinates, colleagues, clients and the community.
26. Other duties as assigned by Supervisor.

MINIMUM QUALIFICATIONS
1. Must have HS Diploma or GED equivalent.
2. Minimum of 3 years’ experience in a healthcare environment.
3. Experience with EPIC
4. Working knowledge of third-party billing regulations.
5. Must be comfortable utilizing 10 key, keyboard and type a minimum of 50 WPM.
6. Extremely well organized and detail-oriented with ability to set appropriate priorities.
7. Must be able to work well independently as well as a part of a team.
8. Must be detailed oriented with organizational skills which involve the ability to prioritize and manage workflow, to produce high quality work, to work independently with minimal supervision and the ability to use good judgement.
9. Must be able to provide TB and Physical clearance prior to start date.
10. CPR certification must be obtained within 90 days and kept current at all times.
11. Ability to employ tact, diplomacy and compassion.
12. Must have a positive attitude and sense of humor.
13. Computer literate – must be familiar with MS Office.

DESIRED QUALIFICATIONS
1. Medical Billing certificate.
2. Fluency in Spanish is desired.
3. Highly experienced in data entry with knowledge of medical software systems.
4. Knowledge of all Medi-Cal payor programs and FQHC billing.
5. Familiarity with the American Indian community.

Benefits: Native American Health Center (NAHC) considers our employees to be our most valuable resource and offers an excellent benefit package: competitive salaries, personal time off (PTO) or sick/vacation leave program, and an employer contribution 403(b) retirement plan to full-time regular status employees. We also provide medical, vision, dental, flexible spending, group term and voluntary life insurance coverage for employees and their dependents—with a percentage of employee contribution for dependent medical premiums.
Note to Applicants: Please be advised a post job offer, pre-employment Physical and TB test are required as a condition of employment. Additionally, you may be asked to get a Department of Justice Fingerprinting clearance as a contingency for an offer of employment. Criminal clearances are obtained to protect the welfare and safety of clients receiving services at NAHC.

EQUAL OPPORTUNITY EMPLOYER: Within the scope of Indian Preference, all candidates will receive equal consideration without regard to race, color, gender, religion, national origin or other non-merit factors.
Age Discrimination in Employment Act (ADEA): Native American Health Center abides by the mandates of the ADEA (protecting individuals 40 years and older) and considers age a non-merit factor in all employment decisions and considerations.
Americans with Disabilities Act (ADA): Native American Health Center abides by the mandates of the ADA and considers disability a non-merit factor in all employment decisions and considerations. Furthermore, NAHC will make any practical, feasible, and reasonable arrangements to accommodate qualified applicants and employees with disabilities.