Billing Representative

Description Under the direct supervision of Billing/Revenue Cycle leadership, with fiscal oversight from the Finance and Accounting Department, the Under the direct supervision of Billing/Revenue Cycle leadership, with fiscal oversight from the Finance and Accounting Department, the Billing Representative is responsible for the full cycle of processing and maintaining all third-party and self-pay billing generated by Tiburcio Vasquez Health Center (TVHC). This position is a key member of the centralized billing team and supports Medicare, Medi-Cal, private insurance, managed care, and other third-party billing and collections across all TVHC providers and facilities. The Revenue Cycle Liaison also provides analytical support to help establish and achieve revenue cycle goals and objectives. Using industry guidelines and best-practice standards, this role supports the optimization of department performance in areas including claims submission, adjudication, denial management, and follow-up on outstanding receivables. Through standard and ad hoc reporting, the Revenue Cycle Liaison identifies opportunities for process improvement and operational enhancement. This collaborative role works closely with providers, medical assistants, front desk staff, and Finance and IT teams to ensure the timeliness, accuracy, and integrity of billing operations. Schedule: This is a full-time position, working 40 hours per week, typically Monday through Friday, with occasional evening or Saturday hours. About TVHC: Tiburcio Vasquez Health Center is a non-profit community health center that is dedicated to promoting the health and well-being of our community by providing accessible, high quality care by integrating primary care, dental care, WIC support, mental health counseling, community health education and more. Benefits: medical (100% paid co-payments, premiums, etc.) dental vision (including dependent and domestic partner coverage) generous paid leave benefits including holidays Flexible Spending Accounts retirement plans with an Employer match tuition reimbursement monthly treats pet insurance and more Compensation: $26.00 - $29.22 per hour, depending on experience. TVHC offers compensation ranges that are determined by a thorough market-based analysis and are fully disclosed in accordance with California law. The pay for a selected candidate is determined by a variety of factors to ensure fair and equitable compensation. We are committed to providing a competitive compensation package that extends beyond base salary, designed to support the health, wealth, and career development of our employees. Responsibilities Establishes, maintains, and updates patient accounts in accordance with TVHC policies and procedures. Works collaboratively with the Finance and Accounting Department to maximize reimbursement under all accepted insurance plans and self-pay arrangements. Performs timely follow-up on denied Remittance Advice/Explanation of Benefits (RA/EOB) for all insurance claims. Develops well-supported, patient-specific appeal documentation for payers when appeals are warranted, including medical necessity and prior authorization denials. Communicate regularly with management and operational staff to support smooth, efficient workflows across health center locations. Maintains current knowledge of billing practices, procedure codes, and payer requirements, and escalates compliance, red-flag activity, and fiscal concerns to appropriate leadership. Monitors workflow across multiple sites to ensure timely billing cycles, consistent monthly submissions, and a high standard of accuracy. Maintains the highest level of confidentiality to safeguard patient information and records. Provides excellent customer service to patients and applies a solutions-focused approach to billing-related concerns and complaints. Supports the integrity of patient account records and related system documentation. Demonstrates the ability to meet or exceed TVHC’s Service Excellence Standards. Performs other duties as assigned. The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and expectations required of the position. Requirements High school diploma or equivalent required. Associate degree in accounting or a related field strongly preferred. Completion of coding and billing coursework required. Minimum of two years of medical practice billing experience required; front-end medical practice experience and operational understanding preferred. Bilingual in English and Spanish required. Experience with Epic electronic billing and electronic health record systems in an FQHC environment. At least one year of accounts receivable experience, including billing, reconciliations, and collections. Qualifications Excellent verbal and written communication skills. Strong analytical skills, including data analysis and review of billing procedures. Proficiency in Microsoft Office applications, particularly Excel, Word, and PowerPoint. Intermediate-level Microsoft Excel skills, ten-key by touch, strong attention to detail, and the ability to interpret contract language and calculate billing adjustments manually. Ability to produce reports and present information clearly and effectively. Excellent interpersonal and customer service skills. Ability to build effective working relationships with providers, front office teams, billing staff, and leadership. #J-18808-Ljbffr