Billing Representative I - Self Pay
About The Position
As a Billing Representative - Self Pay you will be responsible for timely and accurate submission and follow-up of medical or dental claims on behalf of Primary Health Care, Inc. Routinely interacts with various internal and external contacts, including management, third party payers, government agencies and fiscal intermediaries to effectively file claims and research and resolve denials. The billing representative is responsible for completing daily and monthly reporting requirements. Ensures compliance with all State and Federal and third-party payer requirements regarding confidentiality and billing. Responds in a timely manner to billing or patient account inquiries. Demonstrates iCare values in daily work.
Requirements
- High School Graduate or GED.
- Minimum of 1 year experience in dental or medical patient billing (as is relevant to assigned position).
- Experience working with and knowledge of CDT/CPT codes requiring documentation for all dental/medical insurance carriers.
- Understanding of CDT/CPT and ICD-10-CM coding with knowledge of managed care programs and dental/medical billing requirements.
- Experience working with and understanding of dental/medical insurance contractual agreements, Medicare and Medicaid regulations and appeals process.
- Strong technical billing knowledge.
- Excellent written and verbal communication skills.
- Basic computer skills with proficiency using Microsoft Office applications.
- Excellent interpersonal and customer service skills.
Nice To Haves
- Experience using EPIC software, Dentrix software, as well as Centricity software for billing.
- Significant experience in all aspects of billing with a clinical setting.
- Community Health Center experience.
- Proficiency in Microsoft office and computerized patient accounting applications.
- Bilingual in English and Spanish.
Responsibilities
- Submits all medical or dental clinic charges (i.e., dental/medical coding, pay codes, dental documentation submission, etc.) and edits daily, checking accuracy and ensuring compliance with established goals.
- Researches returned dental/medical claim denials to identity billing issues. Obtains the corrected claim information and resubmits the claim, documenting account activity in the appropriate systems, calling third party payers, and monitoring billing reports to follow-up on unpaid submitted claims.
- Completes daily and monthly reporting requirements including closing. Completes secondary dental/medical billing when necessary.
- Checks for compliance with all State and Federal patient financial service issues, including, but not limited to patient-rights such as confidentiality and third party payers.
Benefits
- Generous PTO accrual (equal to 4 weeks at end of 1st year) plus paid holidays
- License/certification fee reimbursement
- Paid time off for continuing education & continuing education reimbursement
- Tuition reimbursement program
- 401k with company match
- Medical insurance - PHC Pays, on average, 80% of medical premiums for all plan types (employee, employee + family, etc.)
- Dental insurance
- Vision insurance
- Life & disability insurance
- Flexible spending & health savings accounts
- Supplemental accident & critical illness insurance
- Discounts on pet insurance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
