CLOSING DATE: Open Until Filled
POSITION: Billing Specialist
SALARY: $17.76-18.65 per hour DOE
REPORTS TO: Chief Financial Officer
Basic Functions: The Billing Specialist reports to the Chief Financial Officer. Individual is responsible for billing for medical/dental/optometry/physical therapy services to various insurances. Individual manages billing processes, which include but is not limited to updating information, generating invoices and processing payments. Individual must be qualified and well-versed in insurance/Medicare/Medicaid and contract health care services provided for LRCHC patients. Individual works independently within the scope of billing requirements as determined by the CFO. Individual must be team oriented and works to support all billing activities. Must understand and follow relevant matters, be caring, communicative, and experienced in dealing with the public and clinical staff. Communication with various healthcare plans for determining benefits and payment processing. Our goal for this position is to contribute to the overall patient satisfaction for their dental service experience.
Education and Training:
- High School Diploma or GED.
- Billing or Coding Certificate (preferred) or willing to complete 1 year training plan to obtain certificates.
- Medical terminology and anatomy (preferred) willing to obtain within 1 year of employment.
- RPMS IHS software or other medical billing software (preferred).
- Understanding of Medicare, Medicaid, commercial carriers, and general healthcare billing guidelines required.
Knowledge, Skills, and Abilities:
- Excellent understanding of ICD9 to ICD10 requirements, CPT coding, Medicare, Medicaid, commercial carriers, and general healthcare billing guidelines is preferred.
- Completes billing encounter by approving claims and submitting CMS-1500, UB or Patient Statement forms within the designated time frame.
- Applies sliding fee discounts, collection, and patient billing policies.
- Accurately records conversations with patients or insurance companies in the patients notes.
- Reviews and acts on Explanation of Benefit (EOB) and Remittance Advice (RAs) to ensure clean claims. Denials will be corrected and resubmitted (when applicable) within 30 days.
- Posts payments in a timely manner into A/R and generates reports as needed.
- Participates in RPMS training as available by staff and I.H.S. May require self-study as directed.
- Regularly reports to billing supervisor any trends, changes, or unusual activity as it relates to billing of services.
- Participate in any set up and implementation changes in computerized billing and collections systems if applicable.
- Performs clerical work including filing, documenting purging, faxing and general office functions.
- Assist with in processing insurance credentialing applications for medical, dental, and behavioral health staff.
- As backup will assist in completing application process to sign providers up as preferred providers or eligible providers for various federal and private insurances.
- As backup will assist in maintaining credentialing data base for medical, dental, and behavioral health staff.
- As backup will assist in maintaining and reconciling daily payments. (Batching and running totals)
Note: Pursuant to Tribal Policy, if this position is safety sensitive it is subject to pre-employment drug testing. In addition, this position is subject to reasonable suspicion and post-accident drug testing.
TRIBAL MEMBER AND INDIAN PREFERENCE WILL APPLY; PREFERENCE WILL ALSO BE GIVEN TO HONORABLY DISCHARGED VETERANS WHO ARE MINIMALLY QUALIFIED.
If required of this position, you must possess and maintain a valid Washington State driver’s license and be eligible for the Tribes’ Vehicle Insurance. In addition, this position may be subject to pre-employment background clearances. If applicable, these clearances must be maintained throughout employment. Documented Covid-19 vaccination is required.
CONTACT INFORMATION: Lake Roosevelt Community Health Centers, Human Resources Department, P. O. Box 290, Inchelium, WA 99138, Contact Leeann Romero, 509-722-7686 or email@example.com