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Northern California Medical Associates is an equal opportunity employer.
Position title: Billing Specialist
Department: Business Office
Location: Santa Rosa, Calif.
Schedule: Monday–Friday, 8:00 a.m.– 4:30 p.m.
Responsible for all aspects of account follow up. Includes submission of appeals, responding to patient and health plan correspondence, telephone calls from offices, health plans, patients and physicians.
Duties and responsibilities
(includes, but is not limited to the following):
- 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.
- Perform various collection actions including contacting patient by phone, correcting and resubmittingclaims to payers.
- Submit supporting documentation according to payer’s clinical policies.
- Monitor open item aging to identify accounts with delinquent items requiring follow up.
- Complete adjustments to remove non-payable services or correct erroneous entries.
- Reconcile accounts.
- Perform billing and charge corrections when identified.
- Process requests for refunds.
- Attend meetings, as requested, and participate in educational activities.
- Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
- 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, ICD-10, 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.
- Ability to read, understand and follow verbal and written instructions.
- Ability to establish and maintain effective working relationships with patients, employees and the public.
- Ability to communicate clearly both written and verbal.
- Skill in answering the telephone in a pleasant and helpful manner.
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 use of telephone.
- Requires manual dexterity to operate 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.
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 environment is typical of a normal office environment. The noise level in the work environment is usually moderate.