Billing Coordinator

Vacancy Posting PureView Health Center has career opportunities for a Full-time, Billing Coordinator. This opportunity, located in Helena, Montana is an in-person/hybrid/remote position within the Billing department and reports to the Revenue Cycle Manager. Make an Impact on Our Community PureView is dedicated to providing the communities we serve with quality, patient-centered, accessible healthcare with comfort. We strive in each encounter to be the leading provider of the highest quality healthcare for our community regardless of a person’s circumstance. At PureView, we value treating our patients, their families and our colleagues with compassion, kindness, and respect. We customize our care according to patient needs and values. And we believe in employing talented, skilled, caring, and responsible people. To us, treating each patient with dignity and as an individual is essential. The Opportunity The Medical Biller is responsible for accurate and timely billing, claims submission, and follow-up for services provided at Pureview Health Center, a Federally Qualified Health Center (FQHC) serving a diverse patient population regardless of ability to pay. This role requires specialized knowledge of FQHC billing methodologies, including the FQHC Prospective Payment System (PPS), encounter-based billing, Medicaid/Medicare wrap-around payments, sliding fee discount program (SFDS) application, and third-party payer requirements. The Biller works closely with front desk, coding, and patient financial services staff to support the health center's revenue cycle and mission of providing accessible, high-quality care to the community. Key Responsibilities: Prepare, review, and submit accurate medical claims to Medicare, Medicaid (including managed care wrap-around claims), commercial insurance, and other third-party payers using FQHC-specific billing rules and encounter rate methodology (PPS/APM). Verify patient insurance eligibility and benefits, and confirm correct application of the health center's Sliding Fee Discount Program (SFDS) based on income and family size documentation. Review encounter forms and superbills for completeness, ensuring CPT, HCPCS, ICD-10, and revenue codes align with FQHC encounter and billing requirements. Post payments, adjustments, and denials from insurance carriers and patients; reconcile against remittance advices (ERA/EOB). Research and resolve claim denials, rejections, and underpayments; prepare and submit timely appeals and corrected claims. Monitor accounts receivable (A/R) aging reports and follow up on unpaid or delinquent claims within timely filing limits. Respond to patient billing inquiries with professionalism and cultural sensitivity, explaining charges, insurance coverage, sliding fee discounts, and payment plan options. Maintain compliance with HRSA Health Center Program requirements, HIPAA, and applicable federal, state, and payer-specific billing regulations. Support month-end close processes and assist with billing-related data needed for UDS (Uniform Data System) reporting and other compliance reporting. Coordinate with coding staff and providers to clarify documentation needed for accurate claim submission. Stay current on payer policy changes, FQHC billing updates, and Medicaid/Medicare bulletins affecting reimbursement. Maintain strict confidentiality of patient information in accordance with HIPAA and organizational policy. Perform other duties as assigned to support the billing department and overall revenue cycle operations. Qualifications: High school diploma or GED required; associate degree in medical billing/coding, healthcare administration, or related field preferred. Minimum of 2 years of medical billing experience required. Certified Professional Biller (CPB) or equivalent billing/coding experience preferred. Experience with electronic health record (EHR) and practice management systems (e.g., eClinicalWorks, NextGen, Epic, or similar) required. Working knowledge of Medicaid managed care wrap-around billing and FQHC PPS/encounter-based reimbursement strongly preferred. Knowledge, Skills, and Abilities Strong working knowledge of CPT, HCPCS, ICD-10-CM coding systems and payer billing guidelines. Understanding of FQHC-specific reimbursement structures, sliding fee discount programs, and 340B program interactions with billing, where applicable. Excellent attention to detail and accuracy in data entry and claims processing. Strong analytical and problem-solving skills for denial management and A/R follow-up. Effective written and verbal communication skills, with the ability to explain billing matters clearly to patients from diverse backgrounds. Proficiency with Microsoft Office (Excel, Word, Outlook) and billing/clearinghouse software. Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment. Commitment to the mission of community health centers and serving underserved populations with compassion and respect. HIPAA requirements. What We Offer: Meaningful work serving underserved communities Inclusive and team-oriented workplace Competitive benefits package include: Health, dental, vision insurance Life insurance 401k Paid time off including PTO, sick leave, holidays, and floating holidays. #J-18808-Ljbffr Socket.dev