Billing Representative

Job Description

Job Description

Salary: $25-27 DOE

Overview

NHHA is committed to employee well-being andmaintaininga healthy work-life integration. The information given below is intended to provide an understanding and appreciation of the workload of the job and its role within NHHA. The job description outlines the main purposes in general terms only. You maybe requiredto carry out other dutiesin order tocommensuratewith the job. This will not change the character or purpose of the job but will be necessary tomaintainhigh standardsof business practice. This job description may be altered from time to time to meet the changing needs of the company.

Job Summary

The Billing Representativeis responsible for managing patient accounts, billing, and ensuring accurateandtimelypayment for medical services. This role involves interacting with patients, insurance companies, and healthcare providers to resolve billing discrepancies, answer inquiries, and process payments. The Billing Representative also ensures compliance with applicable healthcare regulations,maintainsaccuratedocumentation in billing systems, and supports internal teams by providing billing-related reporting and follow-up as needed.

KeyResponsibilities

• Generate and send patient billing statements for medical servicesrenderedin accordance withpayer and organizational guidelines.

• Verify insurance coverage, eligibility, and benefits prior to and following services to ensureaccuratebilling and reimbursement.

• Review patient accounts for accuracy, completeness, and compliance with billing and documentation requirements.

• Work directly with patients to explain charges,establishpayment plans, and resolve outstanding balances in a clear and compassionate manner.

• Submit claims to insurance companies electronically or by mail, ensuring all required documentation and data elements are included.

• Follow up on outstanding claims, underpayments, and denials to ensuretimelyresolution and reimbursement.

• Research, correct, and resubmit denied or rejected claims, including initiating appeals whenappropriate.

• Collaborate with insurance carriers, clearinghouses, and internal teams to resolve billing discrepancies and payment delays.

• Receive, process, and post payments from patients and insurance companies accurately andin a timely manner.

• Reconcile patient accounts and resolve payment posting discrepancies as needed.

• Prepare andmaintainfinancial and billing reports, including accounts receivable, billing trends, and payment collections.

• Address patient inquiriesregardingbilling statements, insurance coverage, payment options, andfinancial responsibility.

• Provide ongoingassistanceand guidance to patients navigating the billing and insurance process.

• Resolve patient concerns and complaints professionally, courteously, andin accordance withorganizational policies.

• Maintainaccurate, detailed, and up-to-date records of patient accounts, billing activities, and communications.

• Ensure compliance with all applicable healthcare regulations, payer requirements, and billing guidelines, including HIPAA.

• Maintain current knowledge of payer rules, reimbursement methodologies, and billing best practices.

• Coordinate with clinical, administrative, and authorization teams to resolve documentation or coding issuesimpactingbilling.

• Assistwith internal audits, billing reviews, and compliance activities asrequested.

• Identifybilling trends, process gaps, or recurring issues and communicate findings to leadership.

• Support continuous improvement efforts aimed at increasing billing accuracy, efficiency, and patient satisfaction.

• Perform other billing- and revenue-cyclerelated duties as assigned.

PositionsRequirements & Qualifications

• High School Diploma or GED equivalentrequired.

• At least1year of experiencein medical billing, accounts receivable or Healthcare administration preferred.

• Strong customer service skills / customer service experiencerequired.

• Proficient in using billing software, electronic health records (EHR)and Microsoft Office applications.

• CalAimexperience desired.

EEO/ADAStatement

NHHA is an equal opportunity organization committed to diversity, equity, and inclusion in all aspects ofserviceand employment. We do not discriminateon the basis ofrace, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected status under applicable law.In accordance withthe Americans with Disabilities Act (ADA), we provide reasonable accommodations for applicants, employees, and students with disabilities. We encourage individuals from all backgrounds to apply.

Disclaimer

This job description is not designed to cover orcontaina comprehensive list of activities, duties, or responsibilitiesrequiredfor the position. Duties and responsibilities may change at any time with or without notice