Billing Clerk

Apply for the Billing Clerk role at Salud Para La Gente
.

Salud Para La Gente (SALUD) provides high quality, comprehensive and cost-effective medical, dental, behavioral health, optometry and other services to underserved, low‑income communities in the Monterey Bay area, including Santa Cruz and Monterey Counties. Founded in 1978 as a storefront free clinic and becoming an FQHC in 1992, SALUD operates four health center sites, satellite and school‑based health centers, and employs over 400 people.

Job Type: Full‑time.

We offer a competitive salary and benefits package and a collaborative culture that values excellence, achievement, innovation and compassion.

We are seeking an experienced Billing Clerk to process assigned superbills and perform other billing functions. This position requires the ability to perform detailed work consistently accurately and timely, and a strong alignment with our mission, vision and values.

• Consistently adhere to SPLG’s communication guidelines and expectations with patients, peers, and supervisors.
• Collaboratively work with patients through SPLG’s communication guidelines to positively affect their health outcomes.
• Enter, review, and make necessary changes to all patient registration information in the practice management system in accordance with established procedures. Ensure that all matters related to patient account information are handled confidentially, effectively, efficiently and in accordance with regulations and contracts.
• Research and answer any questions regarding account balances, bills, or correspondence on a patient’s account in a timely and professional manner and with regard to patient confidentiality.
• Using proper phone etiquette answer incoming calls courteously and professionally.
• Maintain expertise in registration and charge posting in all Salud’s specialties and sub‑specialties for all payers.
• Provide administrative expertise and technical assistance to the Patient Service Coordinators as required for financial and insurance issues.
• Process Salud’s encounters/claims: review all encounters. If errors are found, coordinate with clinical support staff and providers to make corrections for a timely daily close.
• Run unresolved encounter reports that require monitoring and action on a daily basis, and follow up with the appropriate person(s) to resolve outstanding encounters and claims.
• After final review of encounters, prepare the batch for electronic submission.
• Coordinate with fellow billing clerks to finalize electronic encounter/claim submission.
• Maintain a log identifying all errors found while processing encounters. Review daily to identify patterns and report information monthly to Lead, Supervisor or Manager.
• Review health insurance claims to ensure accuracy of payment, denial, rejection received based upon contracts on file, payer guidelines and Salud’s policies/procedures.
• Process Salud’s aged receivables and claim denials: run all reports that require monitoring of claims with the appropriate entity to collect outstanding claims following Salud’s policies and procedures.
• Coordinate required coding changes that may impact payment of a claim in the practice management system.
• Maintain all paper correspondence, including Explanation of Benefits from Insurance Companies organized and filed on a weekly basis.
• Work in coordination with Patient Account Receivable to ensure accurate payments are received. Follow up on all denials received to resubmit accurate data.
• When applicable, participate in individual or group meetings/training related to billing or revenue cycle practices.
• Provide office support and back‑up for the billing department functions as needed, such as posting charges, preparing claims for billing and completing electronic billing batches.
• Coordinate with clinical staff (Providers, Support Staff and Front‑office staff) via tasks, phone, email or in person the following corrections:
• Registration
• Missing charges
• Missing Forms (related to billing)
• Diagnosis codes
• CPT, CDT, HCPCS codes
• Inform patients of Clinic policies regarding minimum payment requirements and financial arrangements such as sliding fee scales and payment contracts.
• Advise…