Job Description
Billing Clerk
Pay: $25-29/hr DOE
Schedule: Monday-Friday, 8:00 AM - 4:30 PM
Location: Alpine, CA 91901
Responsibilities
- Review and validate charge batches, including pre-coding, within the PM/EHR system.
- Ensure all provider-generated charges are received and accounted for.
- Confirm patient eligibility, authorization, and accurate insurance information in the PM system.
- Verify that all required documentation is complete for new patients and specialty programs (Grants, PRC, Direct), including demographics, insurance, and claims data.
- Ensure correct application of CPT, ICD-10 codes, and modifiers for all billable services.
- Process claims daily and resolve claim edits.
- Address and correct claim rejections through the clearinghouse.
- Collect outstanding balances from both insurance carriers and patients.
- Create EFT and fiscal batches, and accurately post insurance and patient payments.
- Prepare, review, and distribute weekly patient statements.
- Establish and manage patient payment plans.
- Monitor and follow up on unpaid claims.
- Submit additional documentation as needed to support timely reimbursement.
- Organize and prepare documentation for effective claims follow-up.
- Analyze EOB and ERA remittance codes to identify denials and zero payments.
- Follow up with payers regarding claim status and routing.
- Communicate payer issues, trends, and concerns promptly with the Billing and Coding Supervisor to ensure resolution and reimbursement.
- Maintain detailed documentation of all account follow-up activities.
- Demonstrate flexibility in scheduling as business needs require.
Ideal Candidate
- Certificate from a medical institution or an Associate degree (AA/AS) required, with a minimum of two (2) years of experience in medical, dental, pharmacy, or behavioral health settings preferred. Prior billing and collections experience is highly desirable. Must have working knowledge of medical terminology, anatomy and physiology, and coding systems including CPT, HCPCS, and ICD-10.
- Experience in IHS/FQHC environments is preferred.
- Familiarity with NextGen Healthcare EHR/EMR systems is a plus.
- Valid California driver's license required at the time of application and must be maintained throughout employment. Candidate must meet insurability requirements under SIHC vehicle insurance policy.
- Relevant certifications and/or licenses appropriate to the role are required.
All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, Los Angeles County Fair Chance Ordinance, and San Francisco Fair Chance Ordinance.
Job Reference: JN -