Medical Biller

Mission Statement: The Mission of JWCH Institute is to improve the health status and well-being of under-served segments of the population of Los Angeles area through the direct provision or coordination of health care, health education, services, and research.

Position Purpose:

The Medical Biller is responsible for reviewing patient encounters, ensuring billing accuracy, and processing claims for various payer sources. This position plays a critical role in maximizing revenue by adhering to payer guidelines, investigating discrepancies, and ensuring timely payment processing. The Medical Biller will also work closely with the Billing Supervisor to provide updates on billing discrepancies, manage rebills, adjustments, write-offs, and ensure payment posting is up to date.

Principal Responsibilities:

1. Review all patient encounters for discrepancies in a timely manner to prevent submission errors to insurance providers.
2. Monitor and update patient information in the patient management system as necessary.
3. Ensure billing accuracy by reviewing all patient encounters across payer sources (insurance, Medicare, Medicaid, etc.) with less than 1% error.
4. Identify discrepancies and initiate necessary corrections promptly.
5.  Adhere to payer-specific guidelines, ensuring all eligible services are billed correctly, and research coverage and non-coverage for all payer types.
6. Investigate and resolve issues related to eligibility, documentation, coding, procedures, and diagnoses. Collaborate with administrators to address any discrepancies found.
7. Post payments accurately for various payers and run reports to verify entries. Track payments, reconcile visits, and apply necessary contractual adjustments or write-offs.
8. Regularly review accounts to identify potential rebills, adjustments, or write-offs, ensuring accuracy in account management and timely follow-up on unpaid charges.
9. Provide weekly updates to the Billing Supervisor, including error reports and updates on billing discrepancies. Assist with preparing reports on billing activities, discrepancies, and revenue trends.
10.  Enter and maintain up-to-date patient information in the management system, ensuring accuracy and compliance.
11. Maintain strict adherence to HIPAA and all other regulatory requirements. Submit weekly encounter verification forms and reports on billing activities.
12. Work closely with the billing team to streamline the revenue cycle, resolve payment delays, and support continuous process improvements.
13. Perform other duties as assigned.

Requirements:  

1. High school diploma or GED Certification.
2. Must possess a Billing Certificate.
3. Must have at least 1 year of Medical billing and collection experience in a Medical office setting.
4. Experience with Medicare, Medi-cal, Cross over insurances, HMO, County and Sliding Fee Discount billing and collection.
5. Typing and computer proficiency skills.
6. Flexible with schedule, willing to travel to multiple sites as needed.
7. Knowledge of healthcare reimbursement, payment posting, and revenue cycle management.
8. Excellent attention to detail with a focus on minimizing errors in billing processes.
9. Strong analytical and problem-solving skills to identify and resolve discrepancies efficiently.
10. Effective communication skills for working with administrators, the billing team, and management.
11. Ability to manage multiple tasks, prioritize work, and meet deadlines consistently.

Preferred:

1. Bi- lingual Spanish and English.
2. Microsoft Excel experience.

*All JWCH, Wesley Health Centers workforce members are recommended to be fully vaccinated and boosted against COVID-19.

Employee Benefits:

JWCH Institute, Inc. offers competitive salaries for all positions. Employees working 30 hours per week or more receive a monthly allowance that can be applied toward medical, dental, and vision premiums. JWCH also provides a partially funded Health Reimbursement Account (HRA), life insurance policies, accidental death and dismemberment policies, short-term and long-term disability plans, Flexible Spending Accounts (FSA) for healthcare and dependent care, employee assistance programs (EAP), generous sick leave plans, vacation time (PTO), 13 paid holidays, a 401(k) Safe Harbor Profit Sharing plan, mileage reimbursement, employee parking, and more!

JWCH Institute, Inc. Wesley Health Centers is an Equal Opportunity Employer.