Summary:

The Revenue Cycle Associate is responsible for all computerized and manual collections and reviewing/posting payments from third parties, including Medi-Cal, CHDP, Medicare, private insurances, Family Pact, Managed Care plans and various other programs and funding sources as assigned. The Revenue Cycle Associate is also responsible for insurance denials, insurance appeals, and patient billing.

Duties:

• Create and submit accurate claims and/or statements for all billable charges, including visit charges and supply charges, in compliance with correct coding initiatives.
• Review hardcopy claims, edit for accuracy and mail or distribute to appropriate third party payer sources or persons on a daily basis.
• Process and monitor assigned claim status categories to be sure that all transactions are captured for month end close. 
• Assist in the preparation of monthly billing and accounts receivable reports.
• Review and process patient eligibility, to include acquisition of authorization numbers as necessary for claims processing.
• Submit patient statements on cash accounts as assigned.
• Post patient and insurance payments to include account balance adjustments and write offs as assigned.
• Review and processing of claims aging and denials as assigned to include claim tracers, corrected claim submissions, appeals, and consistent revenue flow.
• Process and review refunds and insurance recoupment requests.
• Maintain a running monthly total of non-posted payments and record reason.
• Correspond as necessary with State and Federal Medi-Cal and Medicare programs, keeping abreast of all updated information.
• Review and follow-up on all Explanation of Benefits (EOB) or correspondence received on behalf of a a monthly basis.
• Review and follow-up of all overpayments, generating proper refund documentation.
• Discuss escalated billing inquiries with patients, third party payers, and/or sites to resolve account questions and/or problems. 
• Provide customer service internally and externally with professionalism, courtesy, knowledge, and follow through. 
• Become knowledgeable with FQHC billing guidelines, Episodic Programs and the Sliding Fee Discount Program for all Self-pay and Insurance patients.
• Handle Site/Insurance/Patient correspondence received in the department with a sense of urgency and appropriate follow through, as assigned. 

Requirements:

• High school diploma or equivalent.
• At least three (3) years of medical billing experience at a community clinic or in a healthcare setting.
• Knowledge of the revenue cycle process.
• Knowledge of Current Procedural Terminology (CPT), Health Care Common Procedure Coding System (HCPCS) and International Classification of Diseases (ICD) codes.
• Familiarity with insurance payers and funding sources to include manage care plans.
• Knowledge of medical terminology.
• Computer literacy working with PC-based software applications and proficiency with the Microsoft Office suite, including Outlook, Word and Excel.  

Desired:

• Bilingual in English and Spanish.
• Professional Biller, Medical Reimbursement Specialist or Billing & Coding Specialist Certification.

At Truecare, we put your health first. Our compassionate team understands your needs and provides a heartfelt welcome to each and every person who walks through our doors.

Visit truecare.org to learn more! Health Inside. Come in! Salud Adentro. Bienvenido!

Employment is contingent on having an annual COVID-19 vaccination, or use of a mask, from November 1 through March 31 of every year.

Our goal is to promote and ensure authentic inclusion, belonging and support for all team members recruited or employed here.

TrueCare is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, color, religion, creed, national origin, ancestry, sex, gender, age, physical or mental disability, veteran or military status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state, or local law. 

In the spirit of pay transparency, we are excited to share the base salary range for this position. If you are hired at TrueCare, your final base salary (within the pay range), will be determined based on factors such as education, knowledge, skills, and experience. In addition to those factors, we believe in the importance of pay equity and consider the internal equity of our current team members when determining any final offer. Please keep in mind that the range mentioned above is the full base salary range for the role. Hiring at the maximum of the range would not be typical in order to allow for future and continued salary growth. We also offer generous benefits and retirement plans.