DEPARTMENT: Billing

REPORTS TO: Director of Billing

POSITION OVERVIEW:

The billing clerk is responsible to ensure that billing is generated in a timely manner to comply with payer program requirements and to produce reimbursement in a timely manner.

DUTIES/RESPONSIBILITIES:

1. Assists with the productivity which is generated on a weekly basis based on reimbursement rates, visits and revenue sources from all FHCCGLA sites.
2. Reviews and updates as required on an ongoing basis to ensure accuracy in order to maximize reimbursement.
3. Apply knowledge of practice procedures to respond to incoming correspondence and documents.
   1. 1. Posting of charges
      2. Posting of Payments
      3. Follow-up denials
      4. Claims Tracking
      5. Distribution of claims to appropriate payer
      6. Printing of paper claims
      7. Electronic transmission
      8. Tracking of statement/payments
      9. Superbill tracking
4. Generate weekly billing statements on computer and submit to insurance companies.
5. Print and review daily billing statements to ensure correct charges, dates and appropriate notations, and prepare statements for mailing.
6. Correct billing statement discrepancies on computer, and reprint as needed.
7. Photocopy and file all related billing statements and documentation as assigned.
8. Train billers and reception staff as necessary.
9. Coordinate the process of patient eligibility through various third-party sources such as Medicare.
10. Undertakes continuous self-improvement, attending applicable training, seminars, in-services and educational classes to maintain skills competency and current knowledge for standard of care and effective practices.
11. Responsible for following all agency safety and health standards, regulations, procedures, policies and practices.

12. Identifies, initiates and implements measures to ethically maximize billing.

12. Responds efficiently and timely to all patient and provider staff needs and inquiries related to billing, codes, charges, etc.
13. Ensures excellent customer service to all FHCCGLA patients.

15. Resolves patient issues in accordance with company policies & procedures and healthcare regulations.

14. Handles patient grievances according to FHCCGLA’s Policy & Procedure.

17. Assists in developing, updates & reviews of FHCCGLA Policies & Procedures (P&P’s) as needed (with input from all other key personnel).
18. Ensures HIPAA compliance by maintaining strict confidentiality of all patient data and E.H.R./Practice Management System (PMS) according to regulations and FHCCGLA’s P&P’s.
19. Attends the following meetings/trainings:
1. Mandatory Quarterly Staff Meeting/Trainings- Quarterly (Jan., Apr., Jul. & Oct.)- subject to change. 
2. Meetings with FHCCGLA’s Executive Leadership, as needed (advanced notice will be provided when feasible).

15. Other pertinent meetings, trainings and/or conferences- As scheduled
16. Remains informed of:
    1. Current legal and regulatory changes related to scope of practice (FHCCGLA’s services).
    2. Specific programs/payors, insurances accepted, and services being offered at FHCCGLA.
    3. All applicable Policies & Procedures
17. Perform other related duties as assigned.

1. High School Diploma, or equivalent.

2. FQHC experience, highly preferred.

2. Prior accounting and collection experience required.

4. Excellent analytical skills.
5. Motivation to take initiative to ensure all tasks performed are completed thoroughly and accurately.
6. Excellent writing and verbal communication skills.

3. Computer knowledge preferred (e.g., NextGen (E.H.R. & PMS), Microsoft Word and Excel).
4. Transportation is required with valid California driver’s license and state mandated automobile insurance (in the event that transportation to and from other sites is required).
5. Work schedule may include evenings, overtime, and weekends as needed.

10. Ability to prioritize workload and work under pressure of deadlines. 
11. Ability to meet tight time sensitive deadlines.
12. Motivated and committed to the provision of high-quality healthcare for indigent and underserved communities.
13. Willingness to adapt to changes with regards to the agency’s growth and expansion.
14. Ability to speak Spanish, preferred.

ADDITIONAL ELIGIBILITY QUALIFICATIONS:

1. Ability to work well with others in a professional and team-oriented environment
2.  Well-developed interpersonal skills, friendly personality and able to motivate staff by promoting teamwork.
3. Ability to relate to the public regardless of ethnic, religion and economic status.
4. Excellent communication skills.
5. Willingness to travel.
6. Strong planning and organizational skills.
7. Problem analysis and critical thinking skills.
8. Excellent customer service skills.
9. Knowledge of the following (but not limited to), preferred:

                PPO’s                HMO’s         Family PACT                                            CPSP                     Medicare           Medi-Cal     Fee-for-Service                                        CHDP                    Managed Care Plans               Every Woman Counts                              Etc.