With supervision from the Assistant Revenue Cycle Manager, the Revenue Cycle Assistant maintains the medical billing system including all charges and payments and ensures that all medical services provided by the clinic are properly billed and paid.

ESSENTIAL JOB FUNCTIONS:

• Responsible for timely transmission of electronic and manual billing of services rendered. Insurances include: Federally Qualified Health Center (FQHC) Medi-Cal and Medicare and cross over, Medi-Cal Managed Care Alliance, Blue Cross, SB 1194/wrap code18, state programs, CHDP, SOFP, BCDEP, HMO commercial and risk plans, PPOs and Fee-for-service Medi-Cal/Medicare (inpatients and radiology) and other third-party billing.
• Responsible for posting payments for all insurances. Reconcile electronic posting for payments and manually post differences.
• Responsible for processing self-pay billing and follow up on unpaid accounts.
• Assists in claim preparation for all fees for services, third party billing, and follows up on denied/unpaid claims.
• Responsible for posting encounters for CHDP, SOFP, inpatient services, and other third-party billings. Prepare payments for providers for inpatient services.
• Reconciles all managed care capitation and fee-for-service reports for SB 1194/wrap code18.
• Processes and inputs data into Asian Health Services’ (AHS) billing system from Alameda Alliance, Blue Cross, and Healthy Families; scan forms that pertain to OB (pregnant) patients.
• Assists Assistant Revenue Cycle Manager in generating various billing reports as requested for Patient Financial Services Manager to review and other areas of billing as necessary.
• Attends meetings and training related to billing procedures as appropriate.
• Assists clients or Patient Service Representatives with billing questions and making referrals to eligibility workers as appropriate.
• Registers new patients, do intake interviews and assists eligibility workers to update patients’ financial status when needed.
• Responsible for Medicare and Behavior Health service billing to Beacon and Blue Cross Managed care.
• Addresses issues, questions, and problems regarding patient billing from patients, third parties involved in billing, and payers. Adjusts patients’ ledger/accounts as needed.
• Translates for providers, patients, and eligibility Medi-Cal workers, when needed.
• Meets regularly with the Member Services Coordinator to discuss billing problems, other organizational issues affecting billing, and/or changes in third party billing requirements.
• Works closely with the cashier to assure that the accounts receivable system is current and operating smoothly.
• Participate in special AHS internal committees and task forces, as requested.

• Fosters an environment that promotes trust and cooperation among clients and staff.
• Enforces clinic policies and procedures, including maintenance of client confidentiality under HIPAA privacy rules, to ensure that the principles of AHS are implemented.
• Plays an active role in planning organization-wide activities such as AHS general membership meetings, fundraisers, special clinic days, and other events.
• Participates in general membership meetings, fundraisers, and other public events, as required.
• Participates in outreach activities, agency advocacy, and serves on ad hoc committees, as requested.
• Attends AHS staff retreats and Board of Directors meetings, as required.
• Participates in agency-wide quality improvement program processes and performance improvement teams to ensure excellence in the quality of services provided across the agency.

• High school diploma or GED and two years of work experience or equivalent combination of education and experience 

• Bilingual/bicultural in an Asian language preferred.
• Commitment to working in the Asian community, to community health care with familiarity with community health clinics preferred.
• CPT procedure and ICD-10 diagnosis coding preferred

• Knowledge of managed care payment system (government and private) and insurance billing.
• Basic working knowledge of medical terminology.
• Proficiency with Microsoft Office applications, with intermediate to advanced level competency in Excel and PowerPoint
• Demonstrated leadership skills with the ability to train and guide staff in the performance of their duties. Ability to Use of ten-key adding machine.
• Perform tasks and responsibilities in a complete and timely manner, complying with agency policies and standards.
• Work under pressure and in a team environment.
• Ability to communicate effectively, get along with coworkers and management, and deal effectively and professionally under pressure.
• Ability to work collaboratively to achieve common goals and communicate within different levels of the organization.
• Knowledge and experience with cost and fund accounting.
• Ability to multi-task, meet multiple and sometimes competing deadlines.
• Demonstrated ability to effectively manage time, interpersonal relationships, resources and information.
• Strong planning, problem-solving, and organization skills with high attention to detail.
• Strong written and verbal communication skills.

• The physical demands described here are representative of those that must 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.