Billing & Collections Specialist

Billing & Collections Specialist

At ACHC, we are committed to improving the health and well-being of our communities. As a Federally Qualified Health Center and licensed primary care clinic, we provide comprehensive medical and dental services, along with specialized care in Chiropractic, Internal Medicine, Neurology, Pediatrics, Psychology, Podiatry, and Optometry. With clinics located across Fresno, Kings, and Tulare counties, our team works together to deliver accessible, high-quality care to every patient.

The Billing & Collections Specialist performs billing, follow-up and collection procedures, including review and clarification of patient accounts against program provisions (e.g., Medicare, Medi-Cal, Blue Cross, etc.). Resolves routine patient billing inquiries and problems. Oversees the Admission and Discharge clerical functions, and covers those areas as needed. Must have strong working knowledge of computer systems.

Examples of tasks include following prescribed procedures to bill insurance carriers for appropriate payments after verifying patient accounts and insurance data for completeness and accuracy as dictated by carrier procedures and provisions (e.g. Medicare, Medi-Cal, Blue Cross, etc.). Audits charges received from clinic sites. Interprets insurance program procedures and provisions in solution of routine patient billing inquiries and problems. Performs follow-up on balances due from carriers. Follow up on pending/denied claims, correcting and rebilling claims, posting payments and working aging. Following prescribed procedures, may record patient identification data and physician diagnosis, etc. Will record all payments and adjustments to computer systems and reconcile input as appropriate. Will update and maintain billing and provider manuals in a timely fashion. Will inventory supplies and anticipate needed supply items. Performs other routines and duties as requested.

Skills: Qualified candidates will be detail oriented, have strong problem solving skills, and a working knowledge of ICD-10, and CPT codes.

Experience & Education: Working knowledge of NextGen EHR is desirable. High school or equivalent. 1 to 2 years of experience.

Licensure & Certification: Certified in Medical Assisting or Billing is preferred.

Physical/Cognitive Requirements: The physical and cognitive demands listed below represent essential functions of this position and are required with or without reasonable accommodation:

• Hearing: Sufficient to engage with patients and staff in person and by telephone.
• Speaking: Clear verbal communication to convey medical and operational information.
• Vision: Visual acuity adequate for reading printed materials and viewing electronic screens.
• Cognitive Abilities: Aptitude to complete tasks, including abilities such as learning, remembering, focusing, categorizing, and integrating information for decision-making, problem-solving, and comprehending.
• Motor Function & Mobility:
  • Ability to move within the work environment to complete tasks and interact with others.
  • Occasional lifting and carrying of items up to 10 pounds without assistance.
  • Frequent standing, sitting, bending, reaching, and other movements typical of a standard workday.
  • Regular use of hands and fingers for typing, writing, operating tools or equipment, and handling materials.
  • Some pushing and pulling required during daily tasks.

The above is intended to describe the general content and requirements for the performance for this position. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

Benefits: 403(B) matching, Medical Insurance, Dental Insurance, Vision Insurance, Life Insurance, Paid Holidays, Vacation Pay, Sick Pay.

EEO Statement: Aria Community Health Center is an equal opportunity employer and does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor. Aria Community Health Center participates in E-Verify.