Billing Clerk I, II, III

Job Description

Job Description

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.  

Under immediate supervision (Billing Clerk I), or general supervision (Billing Clerk II/III), of the Billing Supervisor or Manager, the Billing Clerk performs a full range of billing and revenue cycle support functions to ensure accurate, timely, and compliant processing of patient encounters and claims. This position supports organizational financial health by managing patient accounts, resolving billing issues, working with clinical and administrative staff, and providing responsive customer service to patients and payers.

This position supports the organization's mission, vision, and values through excellence and competence, collaboration, innovation, respect, commitment to our community, and accountability and ownership.   

DISTINGUISHING CHARACTERISTICS:

Billing Clerk I: This is the entry-level, trainee class in the Billing Clerk series. Incumbents perform routine billing support duties while learning applicable systems, payer requirements, departmental procedures, and revenue cycle operations. Work is performed under close supervision with detailed instructions and review.  

Billing Clerk II: This journey-level classification performs a full range of standard billing, payment posting, claim follow-up, and account resolution duties under general supervision. Incumbents independently process routine work using established procedures and resolve common discrepancies.

Billing Clerk III: This journey-level classification performs, in addition to any Billing Clerk II responsibilities, the most complex or specialized billing functions requiring extensive knowledge of payer rules, billing systems, and revenue cycle processes. Incumbents resolve complex account issues, recurring claim problems, and non-routine discrepancies requiring the most independent judgment.

DUTIES AND RESPONSIBILITIES:

1. Consistently adhere to SPLG communication guidelines and maintain professional interactions with patients, peers, and supervisors. 
2. Support patients with billing matters through effective communication. 
3. Respond to patient inquiries regarding balances, bills, or account correspondence professionally and timely; answer incoming calls courteously using proper phone etiquette.
4. Task the Patient Service Representatives to update registrations or correct registration mistakes; charge posting and assist in payment posting across Salud specialties and payers accurately and confidentially within the practice management system; provide billing support and billing-related technical assistance to staff, clinical and administrative, as needed.  
5. Process encounters and claims, including reviews for errors, coordinating corrections, preparing batches for submission, and logging issues for reporting. 
6. Manage aged receivables and claim denials, change or correct billing codes, organize insurance correspondence and ensure accurate payments. This includes supporting payment posting, credit balance review, refunds, reconciliation activities, and coordination with Finance on revenue tracking and audits. 
7. Receive billing or revenue cycle in-service training and meetings as needed. 
8. Provide office support and backup for billing department functions, including posting charges and payments and preparing claims, assisting with month-end close. 
9. Coordinate with clinical staff to correct registration, missing charges/forms, and billing code issues (diagnosis, CPT/CDT/HCPCS). 
10. Communicate clinic payment policies and financial arrangements to patients. 
11. Maintain effective working relationships with diverse patients, employees, and partners. 
12. Support administrative tasks such as faxing, scanning, or sending patient financial records. 
13. Manage delinquent accounts by establishing and monitoring payment arrangements. 
14. Adhere to SPLG Mission, Vision, Values, Standards of Conduct, and HIPAA principles. 
15. Perform other billing duties as assigned.  

EMPLOYMENT STANDARDS:

Knowledge of:

• Medical billing software and electronic health record (EHR) systems. 
• Federal and state health insurance rules and regulations. 
• Effective customer service skills for both internal and external stakeholders. 
• Familiarity with business email, communication systems, outlook and internet search capabilities. 
• Standard office practices and use of standard office equipment. 
• Basic math proficiency. 
• Health Registration practices and procedures. 
• Records procedures, medical terminology, and computerized recordkeeping. 

Ability to:

• Operate a 10-key calculator on a computer quickly and accurately. 
• Type a minimum of 35 wpm. 
• Perform required billing functions with a high degree of accuracy and appropriate speed. 
• Interface professionally and sensitively with all levels of personnel, including people of all social, cultural, and ethnic backgrounds. 
• Strong attention to detail and accuracy in data entry. 
• Communicate effectively with Salud internal and external departments, insurance companies, patients, and healthcare providers. 
• Handle sensitive and confidential information in compliance with HIPAA regulations. 
• Prepare required reports. 
• Follow organization policies and procedures. 
• Organize and prioritize work efficiently. 
• Use sound independent judgment and think independently and analytically. 
• Develop and maintain effective working relationships with Salud Para La Gente internal and external stakeholders. 

MINIMUM QUALIFICATIONS:

Billing Clerk I

• High School Diploma or equivalent. 
• One (1) year of healthcare front office or healthcare administration experience. 
• Bilingual Spanish/English 
• Medical billing experience or internship/coursework in medical billing is desired. 
• Experience working in a specialty and or/FQHC community clinic is desired. 

Billing Clerk II

• High School Diploma or equivalent. 
• One (1) year of experience equivalent to Salud’s Billing Clerk I classification. 
• One (1) year of medical billing experience required. 
• Bilingual Spanish/English 
• Experience working in a specialty and or/FQHC community clinic is desired.

Billing Clerk III

• High School Diploma or equivalent. 
• One (1) year of experience equivalent to Salud’s Billing Clerk II classification. 
• Two (2) years of medical billing experience required. 
• Bilingual Spanish/English 
• Experience working in a specialty and or/FQHC community clinic is desired. 

Licenses and Certifications:

• Certification in Medical Terminology, Medical Billing, Medical Coding, or a related field for Billing Clerk II/III 
• Possession of a valid California Class C Driver License or ability to provide suitable transportation between sites. 

PHYSICAL DEMANDS:

• Standing, walking, sitting, typing, reaching, bending, moving and/or lifting up to 50 pounds. 

SALARY & BENEFITS

Salary Range:

• Billing Clerk I: $22.22 - $27.50 an hour
• Billing Clerk II: $23.77 - $29.61an hour
• Billing Clerk III: $25.55 - $31.84 an hour

Employment Type:

Benefits: available to all regular Salud employees working 24+ hours per week. Part-time employees may receive some benefits on a pro-rated basis.

• Medical, Dental, Vision, and Life Insurance Plans
• Paid Time Off (PTO): 19 days per year
• Paid Holidays: 13.5 per year
• 401(k) Retirement Plan with employer contribution
• Voluntary Long-Term Disability

**Salud is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Salud is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. To request reasonable accommodation, contact the Salud Human Resources Department, View phone number on ziprecruiter.com, and View email address on ziprecruiter.com].