Billing & Collection Specialist

Billing And Collections Specialist

The person in this position will work independently dealing with Medicare, Medicaid, local contracts, commercial insurances, and self-pay patients in accordance with CMS, AHCA, HRSA, and payer guidelines.

Good oral and written communication skills are required for this position. The information must be exchanged using tact and persuasion appropriately. The person in this position must be able to communicate with the patients, staff, and others; and contribute to a positive environment. Bilingual English Spanish, or Creole preferred, but not required.

Key responsibilities include:

• Ensure charges are dropped daily for Athena processing.
• Monitor's work-flow dashboards and claims worklists to ensure claims follow up in accordance with timely filing and appeal guidelines.
• Review denial management reports and identifies trends and opportunities for process improvement elevates to Business Services Manager for discussion and action plans.
• Special Contract billing and eligibility verification (Ryan White, Project Response, etc.)
  • Ensures monthly claims submission guidelines are in adherence with payer requirements.
• Review appointment schedules for insurance eligibility prior to appointments and assist with resolution prior to the scheduled time.
• Answers call and help patients with insurance and billing questions.
• Data entry of monthly lab charges
• Review and update patient accounts based on sliding fee eligibility.
• Other duties and responsibilities as assigned.
• May occasionally need to travel from one location to another.

Education & training:

• High School Diploma or GED required
• FQHC experience a plus
• A college degree is preferred but not required
• Certification in billing and coding preferred

Experience:

• Minimum three (3) years of experience in medical billing and coding
• Minimum two (2) years experience with self-pay and third-party collections

Requirements:

• Level 2 background clearance required
• Proof of immunizations for (1) Tdap, (2) MMR's, HEP B vaccination, and either a history of chickenpox (varicella) or documentation of the varicella vaccine, a PPD Test is done once upon hire (if applicable to the position)

WFHC reserves the right to change or modify the job description, including but not limited to major responsibilities, education, certification, and physical requirements.

WFHC is an EOE.