Billing Control Clerk

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Responsible to ensure accurate and appropriate medical and dental billing, claim submission, payment posting, and subsequent follow up on rejected or denied claims. Duties include charge entry, payment posting, and denial entry.  Maintains accurate departmental files of fee tickets, bulletins, and other required documentation.  Ability to run, read, and comprehend eligibility messages. Exhibits the four core values of respect, integrity, innovation and compassion.

• Works with other billing staff in initiate billing of claims, rebill as necessary, appeal denials, and modify payers as necessary, file paper claims, follow-up on accounts until zero balance or turned over for collection.
• Review statements organized by alphabet. Task encounters for Bad Debt and Write –off.
• Manual charge entry of paper fee tickets, i.e. Family Pact, CDP, hospital, and home visits.
• Utilize EHR documentation to ensure accurate charge and code entry in case of conflict (denial).
• Accurate posting of payments and denial adjustments received from third parties and patients.
• Utilize Medicare FISS system to follow up Medicare denied claims.
• Follow up on credit balance and unapplied credit reports.
• Requests adjustments to accounts based on organizational guidelines.
• Maintains required billing records, reports, files.
• Assist with front office error resolution, including completion of assigned tasks.
• Tutor Front office on error correction and work flow management.
• Assist with telephone inquiries and provides information requested.
• Periodic feedback to Billing Manager and Revenue Cycle Manager.
• Backup for electronic claims submission.
• Scan explanation of benefits into system for reference.
• Monthly reporting to Billing Manager of status of assigned accounts older than 90 days based on A/R aging reports and participates in educational activities.
• Maintains strictest confidentiality.

KNOWLEDGE, SKILLS AND ABILITIES

• Ability to work without direct supervision.
• Ability to take directions and meet deadlines in a timely manner
• Knowledge of medical terminology, including CPT and ICD 10, and clinic systems
• Current Knowledge of medical billing, accounting procedures and applications, particularly as  they relate to FQHC operations. And Encounter Rate Billing
• Knowledge of claims review, analysis, and quality assurance.
• Basic working knowledge of Microsoft Office, including Outlook, Excel, and Teams.
• Knowledge of commercial insurance and government reimbursement programs.
• Possess good verbal and written communication skills.
• Multi-task oriented with attention to detail.

EDUCATION AND EXPERIENCE REQUIREMENTS

• High school graduate or equivalent.
• 10 key by touch, type 45 wpm.
• Three years’ experience using computer application software.
• Minimum 2 years related experience, preferably with NextGen Program.

• Competitive Wages
• Medical Insurance
• Dental Insurance
• Vision Insurance
• 403 (b) Retirement Plan with matching employer contribution
• Long-term Disability coverage
• Accidental Death and Dismemberment
• Life Insurance
• Flexible Spending Account
• Paid Vacation
• Paid Holidays
• CME with stipend
• Employee Assistance Program
• Jury Duty Pay
• Bereavement Pay
• Health Club Membership Discounts
• Prescription Discount Program
• 529 College Savings Plan
• Educational Reimbursement
• Free subscription based App for Meditation and Sleep
• Free Teledoc service for benefit eligible employees