Job Details

Medical Billing Specialist

Community Clinic is a trusted regional healthcare system dedicated to delivering exceptional, whole-person care in a compassionate, professional, and welcoming environment. As we continue to grow across the region, we remain grounded in one belief: people matter. That includes our patientsand our team. Every employee plays a vital role in living out our promise: We care. You belong.

Job Summary

Community Clinic is seeking a motivated individual to work in a fast-paced Medical Billing office serving multiple providers. Key responsibilities include determining insurance coverage and eligibility, reviewing diagnosis and procedure code combinations using ICD-10, preparing and submitting claims to insurance, accounts receivable follow-up, and providing excellent patient account customer service. This is a full-time and in-person with a schedule of Monday - Friday 8:00 AM - 5:00 PM.

Key Responsibilities

• Prepares and submits medical and dental claims to Medicaid, Medicare, commercial insurance and private pay patient accounts.
• Analyzes rejected claims, corrects errors, and resubmits claims to payer for payment.
• Updates information in software on patient accounts when new information comes available.
• Posts reimbursement checks in software as received.
• Analyzes denied claims, submits corrected claims when necessary, and reports anomalies to supervisor.
• Works with third party payers on billing problems, denials and requests for information.
• Communicates with patients regarding issues affecting payment such as coordination of benefits, third party payers, Medicare replacement plans, and primary care physicians.
• Researches outstanding claims, corrects errors, communicates with payer, and resubmits for payment.
• Handles patient billing complaints professionally and expeditiously.
• Prepares financial records for release when requested and authorized.
• Has knowledge of sliding scale discount procedures and adjusts accounts as necessary.
• Adheres to applicable regulatory guidelines and laws including but not limited to HIPAA/HITECH, HRSA, NCQA PCMH and OSHA.

Skills

• Proficient knowledge of computer software such as Microsoft Office Software
• Attention to detail and high level of organization
• Able to perform proficiently on current practice management system and/or electronic medical records, as well as billing related to software and web-based applications.
• Ability to work and function independently and within a team.
• Strong interpersonal skills and the ability to work effectively with people of all backgrounds.
• Engages in professional development activities, such as trainings and CEU's.

Required Qualifications

• High School diploma or equivalent required.
• Basic eligibility verification experience required.

Preferred Qualifications

• Accounting experience preferred.
• Medical front desk coordinator experience preferred.

Why Join Community Clinic?

• Be a part of a mission-driven organization committed to providing access to health-care to everyone in your community!
• Excellent Benefits Package including:
• Health Vision, Dental and Life Insurance
• 403(b) Retirement plan (automatic employer contribution of 5% per paycheck!)
• Paid Time Off and Holidays
• Employee Discounts for Care