What are the responsibilities and job description for the Billing & Collection Specialist position at Whole Family Health Center?
Whole Family Health Center
A non-profit community healthcare organization serving Florida’s Treasure Coast region for over 25 years as an integrated approach to healthcare providing access to Adult & Pediatric Primary Care, Behavioral Health, and Pharmacy with delivery services. Whole Family Health Center is committed to delivering compassionate, quality care to all!
Billing and Collections Specialist
The person in this position will work independently dealing with Medicare, Medicaid, local contracts, commercial insurances, and self-pay patients in accordance with CMS, AHCA, HRSA, and payer guidelines.
Communication
Good oral and written communication skills are required for this position. The information must be exchanged using tact and persuasion appropriately. The person in this position must be able to communicate with the patients, staff, and others; and contribute to a positive environment. Bilingual English Spanish, or Creole preferred, but not required.
Key Responsibilities
WFHC is an EOE.
A non-profit community healthcare organization serving Florida’s Treasure Coast region for over 25 years as an integrated approach to healthcare providing access to Adult & Pediatric Primary Care, Behavioral Health, and Pharmacy with delivery services. Whole Family Health Center is committed to delivering compassionate, quality care to all!
Billing and Collections Specialist
The person in this position will work independently dealing with Medicare, Medicaid, local contracts, commercial insurances, and self-pay patients in accordance with CMS, AHCA, HRSA, and payer guidelines.
Communication
Good oral and written communication skills are required for this position. The information must be exchanged using tact and persuasion appropriately. The person in this position must be able to communicate with the patients, staff, and others; and contribute to a positive environment. Bilingual English Spanish, or Creole preferred, but not required.
Key Responsibilities
- Ensure charges are dropped daily for Athena processing.
- Monitor’s work-flow dashboards and claims worklists to ensure claims follow up in accordance with timely filing and appeal guidelines.
- Review denial management reports and identifies trends and opportunities for process improvement elevates to Business Services Manager for discussion and action plans.
- Special Contract billing and eligibility verification (Ryan White, Project Response, etc.)
- Ensures monthly claims submission guidelines are in adherence with payer requirements.
- Review appointment schedules for insurance eligibility prior to appointments and assist with resolution prior to the scheduled time.
- Answers call and help patients with insurance and billing questions.
- Data entry of monthly lab charges
- Review and update patient accounts based on sliding fee eligibility.
- Other duties and responsibilities as assigned.
- May occasionally need to travel from one location to another.
- High School Diploma or GED required
- FQHC Experience a plus
- A college degree is preferred but not required
- Certification in billing and coding preferred
- Minimum three (3) years of experience in medical billing and coding
- Minimum two (2) years experience with self-pay and third-party collections
- Level 2 background clearance required
- Proof of immunizations for (1) Tdap, (2) MMR’s, HEP B vaccination, and either a history of chickenpox (varicella) or documentation of the varicella vaccine, a PPD Test is done once upon hire (if applicable to the position)
WFHC is an EOE.
