Medical Biller

Access to Healthcare Network (AHN) is a mission-driven nonprofit dedicated to improving access to quality healthcare and supportive services. We foster a collaborative, respectful, and dynamic work environment where team members feel valued and supported. Joining AHN means contributing to meaningful work that positively impacts seniors, individuals with disabilities, and underserved community members.

The Access Medical Discount Plan Biller is responsible for managing Access Medical member billing for participating healthcare facilities, assisting members in navigating the billing process, and assessing socioeconomic status to determine eligibility for available programs and services. This position ensures accurate billing, provides exceptional customer service, and supports members in accessing affordable healthcare resources.

• Provide compassionate, professional, and member-centered customer service.
• Respond to member, provider, and internal communications within 48 hours.
• Review, research, and correct patient bills, statements, and billing discrepancies.
• Process and submit clean claims accurately and timely to participating healthcare providers.
• Price and adjust claims in accordance with Access Medical Discount Plan guidelines.
• Follow up on unpaid claims and outstanding balances with providers and members.
• Investigate and resolve patient billing concerns, complaints, and account issues.
• Evaluate members' financial and socioeconomic status to determine eligibility for available programs and services.
• Verify and maintain member eligibility and enrollment information.
• Report delinquent accounts and assist with collection efforts in accordance with organizational policies.
• Input and process 40 to 60 claims daily while maintaining accuracy and productivity standards.
• Confirm claim payments and reconcile member accounts.
• Maintain accurate records and documentation in applicable databases and software systems.
• Ensure compliance with AHN policies, confidentiality requirements, and applicable regulations.
• Perform other duties as assigned to support Access Medical operations.

• Maintain compliance with HIPAA, AHN policies, and all applicable confidentiality and privacy regulations.
• Demonstrate a thorough understanding of Access to Healthcare Network (AHN) programs, services, policies, and procedures.
• Utilize Salesforce and other organizational databases to accurately document member interactions, billing activities, claims, and referrals.
• Input and process referrals associated with member claims and healthcare services.
• Adapt effectively to changing priorities, workflows, and business needs in a fast-paced environment.
• Attend and actively participate in staff meetings, trainings, and organizational events as required.
• Maintain professional communication and collaboration with members, providers, and AHN staff.
• Complete assigned projects and administrative tasks in a timely and accurate manner.

• Bilingual (English and Spanish) required.
• High School Diploma or equivalent required;
  Associate Degree (AA) preferred.
• Minimum of one (1) year of medical billing and claims processing experience preferred.
• Minimum of two (2) years of experience working with databases, electronic record systems, and software applications.
• Proficiency in Microsoft Office Suite, including Word, Excel, Outlook, and PowerPoint.
• Excellent customer service, communication, and organizational skills.
• Strong verbal and written communication skills.
• Strong attention to detail and commitment to accuracy.
• Ability to manage multiple tasks, prioritize workloads, and perform effectively under pressure.
• Ability to work independently and exercise sound judgment when handling member and provider accounts.
• Flexibility to adapt to changing priorities, work assignments, and schedules.

• Experience working in a healthcare, medical billing, insurance, or patient account environment.
• Experience using Salesforce or similar customer relationship management (CRM) systems.
• Knowledge of healthcare terminology, billing procedures, and eligibility determination processes.
• Experience working with diverse and socioeconomically disadvantaged…