Billing Clerk

Description

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. SALUD began in Watsonville in 1978 as a storefront free clinic, and became a FQHC (Federally Qualified Health Center) in 1992. With four health center sites, satellite and school-based health centers and over 400 employees, we provide high quality services to patients of all ages.

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 super bills and perform other billing functions. This position requires the ability to perform detailed work in a consistently accurate and timely manner. The ideal candidate will embrace our mission, vision and values, and demonstrate sound independent judgment and think independently and analytically.

The selected candidate will possess knowledge of basic and computerized accounting procedures, especially relating to billing of health insurances and state programs.

Responsibilities include, but are not limited to, the following:

• Reviews all encounters. If errors are found, responsible to coordinate with clinical support staff and providers to make corrections in order complete a timely daily close.
• Runs unresolved encounter reports that require monitoring and action on a daily basis, and follows up with the appropriate person(s) in an effort to resolve outstanding encounters and claims.
• After final review of encounters, prepares the batch for electronic submission.
• Coordinates with fellow billing clerks to finalize electronic encounter/claim submission.
• Maintains a log identifying all errors found while processing encounters. Reviews daily to identify patterns. Reports information monthly to Lead, Supervisor or Manager.
• Reviews health insurance claim to ensure accuracy of payment, denial, rejection received based upon contracts on file, payer guidelines and Salud’s policies/procedures.

• Runs all reports that require monitoring of claims with appropriate entity in an effort to collect outstanding claims following Salud’s policies and procedures.
• Coordinates required coding changes that may impact payment of a claim in the practice management system.
• Maintains all paper correspondence including Explanation of Benefits from Insurance Companies organized and filled on a weekly basis.
• Reviews health insurance claim to ensure accuracy of payment, denial, rejection received based upon contracts on file, payer guidelines and Salud’s policies/procedures.
• Works in coordination with Patient Account Receivable to ensure accurate payments are received. Follow up on all denials received to resubmit accurate data.