Medical Biller

Title: Access Medical Discount Plan (AM) - Biller

Reports to: Access Medical Discount Plan (AM) - Assistant Director

Supervises: No one

Based at: Access to Healthcare Network - Reno

Status: Non-Exempt

About Access to Healthcare Network (AHN)

Access to Healthcare Network (AHN) is a mission-driven nonprofit dedicated to improving access to quality healthcare and supportive services. We foster a collaborative, respectful, and dynamic work environment where team members feel valued and supported. Joining AHN means contributing to meaningful work that positively impacts seniors, individuals with disabilities, and underserved community members.

JOB PURPOSE

The Access Medical Discount Plan Biller is responsible for managing Access Medical member billing for participating healthcare facilities, assisting members in navigating the billing process, and assessing socioeconomic status to determine eligibility for available programs and services. This position ensures accurate billing, provides exceptional customer service, and supports members in accessing affordable healthcare resources.

KEY RESPONSIBILITIES AND ACCOUNTABILITIES

• Provide compassionate, professional, and member-centered customer service.
• Respond to member, provider, and internal communications within 48 hours.
• Review, research, and correct patient bills, statements, and billing discrepancies.
• Process and submit clean claims accurately and timely to participating healthcare providers.
• Price and adjust claims in accordance with Access Medical Discount Plan guidelines.
• Follow up on unpaid claims and outstanding balances with providers and members.
• Investigate and resolve patient billing concerns, complaints, and account issues.
• Evaluate members' financial and socioeconomic status to determine eligibility for available programs and services.
• Verify and maintain member eligibility and enrollment information.
• Report delinquent accounts and assist with collection efforts in accordance with organizational policies.
• Input and process 40 to 60 claims daily while maintaining accuracy and productivity standards.
• Confirm claim payments and reconcile member accounts.
• Maintain accurate records and documentation in applicable databases and software systems.
• Ensure compliance with AHN policies, confidentiality requirements, and applicable regulations.
• Perform other duties as assigned to support Access Medical operations.

ADDITIONAL REQUIREMENTS

• Maintain compliance with HIPAA, AHN policies, and all applicable confidentiality and privacy regulations.
• Demonstrate a thorough understanding of Access to Healthcare Network (AHN) programs, services, policies, and procedures.
• Utilize Salesforce and other organizational databases to accurately document member interactions, billing activities, claims, and referrals.
• Input and process referrals associated with member claims and healthcare services.
• Adapt effectively to changing priorities, workflows, and business needs in a fast-paced environment.
• Attend and actively participate in staff meetings, trainings, and organizational events as required.
• Maintain professional communication and collaboration with members, providers, and AHN staff.
• Complete assigned projects and administrative tasks in a timely and accurate manner.

EDUCATION AND EXPERIENCE

Minimum Qualifications

• Bilingual (English and Spanish) required.
• High School Diploma or equivalent required; Associate Degree (AA) preferred.
• Minimum of one (1) year of medical billing and claims processing experience preferred.
• Minimum of two (2) years of experience working with databases, electronic record systems, and software applications.
• Proficiency in Microsoft Office Suite, including Word, Excel, Outlook, and PowerPoint.
• Excellent customer service, communication, and organizational skills.
• Strong verbal and written communication skills.
• Strong attention to detail and commitment to accuracy.
• Ability to manage multiple tasks, prioritize workloads, and perform effectively under pressure.
• Ability to work independently and exercise sound judgment when handling member and provider accounts.
• Flexibility to adapt to changing priorities, work assignments, and schedules.

Preferred Qualifications

• Experience working in a healthcare, medical billing, insurance, or patient account environment.
• Experience using Salesforce or similar customer relationship management (CRM) systems.
• Knowledge of healthcare terminology, billing procedures, and eligibility determination processes.
• Experience working with diverse and socioeconomically disadvantaged populations.

WORK ENVIRONMENT

• The noise level in the work environment is usually moderate, and the employee usually works in a climate-controlled office environment.
• Be able to sit at a computer for 6 - 8 hours per day.
• Be able to stand between 3 - 6 hours per day.
• Be able to withstand hand/wrist deviation and repetition.
• Must be able to lift, carry up to 30 pounds with a fair consistency.

FUNDING CLAUSE

This position is funded through external grant sources. Continued employment is contingent upon the ongoing availability of this funding. If funding is reduced or discontinued, the position may be changed or eliminated.

As an equal opportunity employer, we are committed to identifying and developing the skills and leadership of people from diverse backgrounds. We encourage all qualified candidates to apply.

Benefits:

• Medical InsuranceVision provided at no cost to the Employee
• Health Savings Account HDHP (HSA) includes employer matching $35.00 per month
• Dependent Care Flexible Savings Account (FSA)
• Low-cost health insurance options for your dependents
• Dental insurance
• Free Life Insurance and Long-Term Disability
• Voluntary Ancillary Benefits
• 4 Weeks Paid Time off in your first year
• WFH Options
• 14 Holidays
• Bereavement Leave
• 4 weeks Paid parental leave
• Tuition Assistance and more!