SUMMARY:

Under the supervision of the Billing Supervisor, the Medical Government Biller maximizes the amount and timeliness of receipt of billed fees on patient accounts for Medi-Cal, Medi-Care, Crossovers, and Medi-Cal/CHDP. Working proactively within the unit and interdepartmentally, this person maintains targets to achieve revenue targets based on billable encounters.

EXPECTATIONS:

• Arrives on time and adheres to set schedule.

· Ensures timely billing and follow up for patient services

· Prepares accurate reports of patient charges, payments, and adjustments

· Maintains open communication with supervisor and all staff

· Collects and records data accurately

· Works flexible or extended hours where necessary

· Demonstrates awareness and compliance of the corporate and organizational mission and objective of Camarena Health to promote health care access for all members of the community.

· Billing adjustments are minimal due to proactive, effective billing and follow up: i.e. revenue is maximized

· Use of professionalism and best efforts in your position.

DUTIES and RESPONSIBILITES

1. Focus on Billing:

1.1. Initiates timely billing and earliest and greatest possible receipt of fees for Medi-Cal, Medi-Care, Crossovers, and CPSP, EAPC and hospital services.

1.2. Prepares electronic billing of Medi-Cal and Medi-Care claims and reviews to ensure accuracy

1.3. Enters adjustments for Medi-Cal, Medi-Care, Crossovers, and if appropriate, generates refund requests

1.4. Consistently follows-up and re-bills adjustments per Camarena Health standards so that revenue lost is minimal

1.5. Maintains targets; works with team to assure revenue generation is maximized

2. Focus on Records, Statistics, and Data:

2.1. Consistently prepares accurate monthly statistical reports that include number of patient charges, payments, adjustments, and log

2.2. Prepares daily deposits accurately and timely

2.3. Trains and provides feedback to staff involved in preparation of records and transaction sheets to assure in accuracy of all such records

2.4. Performs special data collection projects and other assignments within agreed upon timelines

2.5. Prepares quarterly Medi-Care Credit Balance Report accurately and timely

2.6. Prepares annual PPS reconciliation report

2.7. Assists in the preparation of Medi-Care cost reports.

3. Focus on Teamwork:

3.1. Various other duties as assigned by supervisor. Duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally, either verbally or in writing

3.2 As a team member of Camarena Health, the Medical Government Biller respects and protects information regarding patients and other team members and abides by the rules of the Confidentiality Protocol

3.3 Assists and backs-up other Billing staff as necessary

3.4 Participates in health center in-services, listening and respecting others’ ideas

3.5 Abides by Rules of Confidentiality

Minimum Requirements:

Education:

· High School Diploma or equivalent

Prior Experience:

· Three to four years experience in medical third party billing and statistical record keeping; computerized data experience

Skills:

· Excellent oral and written skills

· Mathematical accuracy

· Medical terminology and diagnostic indexing

· Revenue billing and collection problem-solving

· Telephone courtesy; customer-service oriented

· Modern office practices and procedures including email

· Intermediate computer skills

· Attention to detail, perseverance, timeliness, and excellent follow-through on work tasks

· Demonstrated good problem-solving skills

· Able to handle multiple tasks simultaneously

· Able to quickly build and maintain rapport with patients and providers of differing backgrounds; team player

Physical Requirements:

• Must be able to move up to 20 pounds and push up to 50 pounds (on wheels).
• Must be able to hear staff on the phone and those who are served in-person, and speak clearly in order to communicate information to clients and staff.
• Must be able to have vision that is adequate to read memos, a computer screen, personnel forms and clinical and administrative documents.
• Must have high manual dexterity.
• Must be able to reach above the shoulder level to work, must be able to bend, squat and sit, stand, stoop, crouching, reaching, kneeling, twisting/turning.