Billing Specialist

The Sacramento Native American Health Center Inc. (SNAHC) is a non-profit 501 (c)(3) (Federal Tax ID # 20-4287737) Federally Qualified Health Center, with multiple locations in Sacramento, CA. The health center is committed to meeting patients where they are and supporting their health goals through the provision of culturally competent, holistic, and patient-centered continuum of care.

At SNAHC, you are joining a team and organization at a time of growth and transformation. You will love being surrounded by people who are as passionate as you are about community health. Individual compensation for this position will be determined at the organization’s discretion and the wage range for this role considers multiple factors including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. It is not typical for an individual to be hired at or near the top of the salary range and compensation decisions are determined thoughtfully in each case. A reasonable estimate of the current range is $18.97 to $25.66 per hour.

Essential Functions:

• Coordinate the collection of data from point of origin; participate in the pre-processing of patient data to locate missing information and to make corrections as necessary.
• Submit claims on a daily basis.
• Post payments received.
• Share patient payment information on a daily basis.
• Review Sphere 2 provider training documentation.
• Point of contact for state programs including, but not limited to CHDP, Family Pact, Every Women Counts, etc.
• Process daily pending charges.
• Balance batch ledgers when necessary.
• Run and correct any claim edits.
• Run report to check for missing charges from providers.
• Serve as support and provide training for providers when needed.
• Work daily tasks from E.P.M. And E.H.R work logs.
• Stay current and update RCM with any payer specific or FQHC facility information changes.
• Reviews provider coding for accuracy in outpatient medical, dental and behavioral health records.
• Respond to all levels of coding questions.
• Analyze and resolve Revenue Cycle problems effectively by utilizing weekly aging reports to ensure all claims are adjudicated in a timely manner.
• Update patient records when necessary.
• Files and maintains transmittals for billing and auditing.
• Research problem claims, and adjust errors discovered therein.
• Review billing database for trends in claims rejections and resolve these as they occur.
• Review and resolve claim denials.
• Maintain high degree of confidentiality and respect in handling all clinic and client medical information.
• Purging charts that have aged out.
• Actively participates in internal quality improvement teams. Works with members proactively to support quality improvement initiatives in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards.
• Compliance with all state and federal laws and regulations, as they pertain to position including; HIPAA, sexual harassment, scope of practice, OSHA, etc.
• Other duties as assigned.

Minimum Qualifications:

• AA degree or equivalent experience in FQHC insurance, eligibility and/or billing.
• Experience with Medi-Cal, Medicare, and outpatient coding experience or equivalent combination of education.
• Familiarity with computerized Billing systems.

Preferred Qualifications:

• Certified Professional Coder (CPC) or Certified Biller.
• Knowledge and understanding of Community Clinic Third Party revenue processes, FQHC Billing experience.
• Knowledge, understanding and use of Electronic Health/Administrative Records, Resource Patient Management Systems NextGen.