Billing Clerk I

JOB DESCRIPTION

LOCATION:

  •  Corporate Bakersfield

Job Summary: The person handling this position is responsible for correcting, completing, and processing claims of all payer codes. He or She is also required to generate reports from computer in accordance with established procedures.

Job Duties:

  1. Daily key punching into computer when needed to assure accuracy of billing for all services rendered in patients account.
  2. Ensure completion of documentation and coding on the Route Slip and EMR when needed on charges entered in patient’s accounts for a correct and complete billing claim.
  3. Monthly input of all ancillary services to include Health Education Services encounters into the computer to assure accuracy of services rendered.
  4. Daily review of all postings before claim submission.
  5. Daily closing and balancing of day posted.
  6. Enter cash receipts if needed and assure correct allocations, distribution in accordance with the established protocol.
  7. Perform monthly, closing, and balancing no later than the 10th of every month.
  8. Review monthly reports printed. Make arithmetic calculations and check various statistical and accounting tables and reports as required.
  9. Responsible for sending the electronic claims for Medi-Cal, Medicare, and EAPC on weekly basis.
  10. Responsible for sending claims to all private insurance, third party, workers’ comp., hospital billing, CHDP, CHDP-TP, KFHC, Family Planning Program on weekly or monthly basis as directed by the Billing Manager.
  11. Maintain billing file/records by batch in accordance with the established protocol.
  12. All other assignments as directed by the Billing Manager.

Job Requirements:

  1. Ability to work under pressure.
  2. Ability to handle multi-functions.
  3. Understanding of community based organizations.
  4. Ability to communicate with the medical/dental staff and Office Managers.
  5. Some knowledge of bookkeeping and office functions.
  6. Some knowledge of CPT and ICD9 codes.
  7. Ability to work proficiently and efficiently on a timely manner.
  8. Knowledge of all payer codes.
  9. Knowledge of all programs offered by OFH.
  10. Promotes and believes in OFH mission statement.
  11. Ability to relate to the public regardless of ethnic, religion and economic status.

Additional Functions and Responsibilities:

  1. HIPAA compliance – Responsible for maintaining abreast of and in compliance with all HIPAA regulations and requirements. Treats all member information confidential.
  2. Compliance – Ensure compliance with all local, state and federal regulations.
  3. QA/QI – Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.
  4. IT – Required to learn and use the EHR/EOHR (Medical Practice Electronic System) and its components. As required by the job functions and highlighted in the Policies and Procedures. These components include NextGen, PMS, QSI and other electronic features, as they are developed and implemented, as applicable to work environment.
  5. All employees will participate in Patient Centered Health Home Model at Omni Family Health.

Qualifications, Education, and Experience:

  1. High school graduate/GED with one year of experience handling billing and accounts receivables in a similar setting or related field.
  2. Formal training from a vocational school in lieu of the above.
  3. Some training or background in ICD-A / CPT codes.
  4. Some ability to understand and practice bookkeeping and accounting terminology.
  5. Knowledge of medical/dental terminology and billing practices.
  6. Ability to operate computers and other office machines.
  7. Must be able to take responsibility and work under pressure.

Responsible To:         Billing Manager

Classification:            Full or Part Time Position, Non-exempt