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The Billing Specialist is responsible for managing HealthRIGHT360’s clinical database/billing system, including e-Clinical works (ECW) or any other future EMR’s reconciling insurance claims and tracking UDC’s/UOS for HealthRIGHT 360’s medical contracts.
Billing Responsibilities: Under the supervision of HealthRIGHT360’s Revenue Cycle Manager Manager, the billing specialist is responsible for accurate and timely scanning of EFT’s, checks, EOB’s, claim Inquiries, denials, RTD’s and correspondence to PMG or other entities. The position is responsible by obtaining any additional information that may be needed to complete claims (Dx codes, CPT codes, note signatures, etc). Maintain and ensure proper coding for encounters including updates of ICD-10 and CPT codes.
Bank Statement Reconciliations. Weekly Reconciliation the front desk cash logs, co-payments, and deposits to EMR and turn into fiscal. Along with the Revenue Cycle Manager and Directors of Operations investigate, post, and manage EMR payments and deposit into bank.
Under the direction of the Revenue Cycle Manager develop and manage electronic billing system by inactivating and adding new/discontinued CPT and ICD10 codes, updating the Federal Poverty Level, Sliding Scale Fees and Charges on an annual basis.
Regular management of HealthRIGHT 360’s Medical Program’s funding sources, including Medi-Cal, Medicare, Family PACT, Managed Care and Commercial Insurances.
Daily management of Return to Clinic (RTC) errors.
Daily processing of clinic/billing mail and work with PMG and Internal billing department to process ACH, remits, etc. and scan/upload to appropriate folders for processing.
Under supervision of the Revenue Cycle Manager process patient refunds as necessary.
Billing Credentialing:
Notify PMG of all termed/hired employees. Obtain all provider materials needed for credentialing providers with all payer sources. Work with PMG on outstanding AR.
Compliance Responsibilities: Ensure clinic stays in compliance with billing requirements (i.e. Medi-Cal/Medicare/HRSA compliance).
Assist Medical Records department in providing billing records for patients upon request.
Customer Service: Work directly with patients and Revenue Cycle Manager to address patients concerns or billing or statement concerns. As requested work with patients to explain the breakdown of fees and collect payment.
And, other duties as assigned.
Education and Experience Required:
Desired:
Background Clearance Required:
Knowledge Required:
Skills and Abilities Required:
Desired:
In compliance with the California Department of Public Health's mandate, all employees must be able to provide proof of COVID-19 vaccination. Medical and religious exemptions are available.
Tag: IND100.
Full Time
Ambulatory Healthcare Services
$65k-88k (estimate)
04/12/2023
05/02/2024
healthright360.org
LOS ANGELES, CA
200 - 500
1966
$50M - $200M
Ambulatory Healthcare Services
Our Mission HealthRIGHT 360 gives hope, builds health, and changes lives for people in need. We do this by providing compassionate, integrated care that includes primary medical, mental health, substance use disorder treatment and re-entry services. History To address the thousands of adolescents and young adults that were streaming into San Francisco for the cultural revolution of the 1960s, Haight Ashbury Free Clinics (HAFC) opened its doors in 1967 as the first free medical clinic in the country. During the first week of operation over 400 patients were seen. HAFC has been an innovator in d...elivering primary health care services to many of the people who can least afford them. Health Care is a Right, Not a Privilege has been the guiding principle as well as its famous tagline. Walden House was founded in 1969 in the same Haight-Ashbury district of San Francisco to help homeless and runaway adolescents with substance use disorder problems. Today, Walden House treats people with mental health and substance use disorder problems at various residential and outpatient centers throughout California, including in-prison treatment programs, and facilities in San Francisco and Los Angeles, providing drug and alcohol treatment and mental health, vocational and housing services for people transitioning back into their communities. Like HAFC, Walden House has always served people who are uninsured, homeless and socio-economically disenfranchised, including those with HIV/AIDS. Haight Ashbury Free Clinics and Walden House have both grown over the years, becoming national models for community healthcare, substance use disorder treatment and mental health services. The organizations merged on July 1, 2011 to best serve the most vulnerable members of our community. On July 1, 2012, Haight Ashbury Free Clinics Walden House adopted a new name: HealthRIGHT 360. A Growing Family of Programs Asian American Recovery Services (AARS) joined the family of HealthRIGHT 360 programs in 2013. Founded in 1985, AARS has grown to serve thousands of people throughout San Francisco, San Mateo, and Santa Clara counties. In 2014, North County Serenity House of San Diego county and Womens Recovery Association (WRA) of San Mateo joined HealthRIGHT 360, continuing its leadership as a provider of gender responsive services for women and women with children. In 2015 Lyon-Martin Health Services became the third primary care clinic operated by HealthRIGHT 360, continuing its specialized care for women and transgender individuals. Tenderloin Health Services (formerly Glide Health Services clinic) became the fourth primary care clinic in 2015, providing care in San Franciscos Tenderloin neighborhood. Prototypes joined in 2016 expanding behavioral health care for women and children and services to survivors of domestic violence in Los Angeles, Orange and Ventura Counties. Strengthening services for women and girls in San Francisco, Womens Community Clinic joined our family of programs in 2017. Womens Community Clinic traces its roots to the Womens Need Center, a program of Haight Ashbury Free Clinics that closed in 1999 and reopened four months later with its new name.
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