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*Northern California Medical Associates is an Equal Opportunity Employer
Position Title: Billing Specialist Coordinator
Reports To: Director of Business Services or Department Manager
FLSA Status: Non-Exempt
Location: Santa Rosa, CA
Schedule: Full-Time, Monday – Friday, 8:00am to 4:30pm
Summary: Responsible for all aspects of account follow up. Includes submission of appeals, responding to patients, health plan correspondence, telephone calls from offices, patients and physicians. Assists Director of Business Services or Department Manager by overseeing workflow of unit and being primary resource for other Billing Specialists.
Duties and Responsibilities (includes, but is not limited to the following):
• Primary resource for Billing Specialists by assisting with questions and day-to-day workflow.
• Completes electronic statement run and maintains spreadsheet with number of claims submitted each day.
• Monitors email account for the billing department and forwards emails to the appropriate Billing Specialist for response.
• Submit claims to various payers either electronically or by paper.
• Respond to correspondence from patients, staff, physicians and insurance companies.
• Resolve patient billing questions and complaints.
• Prepare, review and send patient statements.
• Review accounts for possible assignment to collection agency.
• Monitor open item aging to identify accounts with delinquent items requiring follow up.
• Perform billing and charge corrections when identified.
• Process requests for refunds.
• This position has no direct supervisory responsibilities.
Education, Licensure and/or Certifications
• High school diploma or GED
• One year of billing experience in a health care organization (additional appropriate education may be substituted for one year of billing experience.
Knowledge, Skills and Abilities
• Extensive knowledge of medical billing and collection practices including insurance company payment policies and fee schedules.
• Knowledge of medical office policies and procedures.
• Knowledge of CPT, ICD-9, and HCPCS coding.
• Knowledge of HIPAA guidelines.
• Knowledge of database functionality, Microsoft Word and Excel.
• Knowledge of basic accounting principles.
• Skill in using computer, adding machine, and other office equipment.
• Ability to examine documents for accuracy and completeness.
Physical Demands: The physical demands described here are representative of those that may need to be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Requires prolonged sitting, some bending, stretching and occasional lifting of up to 25 pounds.
• Requires manual dexterity to operate telephone, keyboard, calculator, copy machine and other office equipment.
• Requires eyesight correctable to 20/20 to read numbers, letters and computer monitor.
• Requires hearing within normal range for telephone use.
Work Environment: The work environment characteristics described here are representative of those an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The work environment is that of a normal office environment.