Billing Specialist - Part-time

Billing Specialist [part-time]

Our client, the Multi-cultural Health Evaluation Delivery System, an organization who values Flexible, Ethical, Positive Communicators, Culturally Competent, Productive, and Team Players has a need for a part-time Billing Specialist for approximately 20 hours per week.
Duties and Responsibilities include, but are not limited to the following:

Administrative Duties

• Responsible for day-to-day billing operations associated with medical and dental services provided by MHEDS.
• Reviews, prepares, submits, and tracks claims to Medicaid, Medicare, commercial insurance carriers, managed care organizations, and other third-party payers.
• Ensures claims are submitted accurately and timely in accordance with payer requirements and organizational policies.
• Monitors claim status and performs follow-up activities on unpaid, rejected, denied, or underpaid claims.
• Researches billing issues and works collaboratively with providers, clinical staff, front office staff, and revenue cycle personnel to resolve claim discrepancies.
• Posts payments, adjustments, denials, and other transactions accurately within the electronic billing system.
• Maintains documentation and records necessary to support billing, reimbursement, compliance, and audit requirements.
• Assists with account reconciliation activities and identifies trends impacting reimbursement, collections, and claim denials.
• Communicates professionally with insurance carriers, patients, and staff regarding billing inquiries, eligibility verification, claims status, prior authorizations, and appeals.
• Assists with preparation of billing reports, collection reports, denial reports, and other revenue cycle metrics as requested.
• Supports organizational efforts to maximize reimbursement, improve collections, reduce denials, and strengthen overall revenue cycle performance. 

• Processes and follows up on dental insurance claims and related documentation.
• Verifies dental insurance eligibility, benefits, limitations, and coverage requirements as assigned.
• Reviews dental coding and claim submissions for completeness and accuracy.
• Coordinates with dental providers and support staff to obtain documentation required for claim submission, claim correction, and appeals.
• Maintains current knowledge of dental billing requirements, payer policies, and reimbursement methodologies.

• Ensures the six domains of healthcare quality are met during each patient visit: patient safety, effectiveness, patient-centered, timeliness, efficiency, and equity.
• Consistent with MHEDS' values, treats all supervisors, co-workers, direct reports, patients, and any other internal or external person with respect and dignity.

Education and/or Experience:

• High School Diploma or equivalent required; Associate’s degree in healthcare administration, business, accounting, finance, or related field preferred.
• Minimum of two years of medical billing experience required.
• Experience with Federally Qualified Health Centers (FQHCs), community health centers, or healthcare organizations preferred.
• Experience with dental billing, dental insurance claims processing, dental coding, and dental reimbursement procedures strongly preferred.
• Experience with Medicaid, Medicare, commercial insurance carriers, and managed care organizations preferred.
• Experience using electronic health records, practice management systems, clearinghouses, and billing software required.
• Knowledge of CPT, ICD-10, CDT, HCPCS, and payer billing requirements preferred.

Continuing Education:

• Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional organizations.

Language Skills:

• Must be able to speak and write in English. Additional language capabilities are a plus.

Safety:

• Adheres to safety, infection control, patient confidentiality, and related policies and procedures.

Physical Demands:

• Normal medical/administrative office setting demands include lifting and carrying or delivering supplies that usually weigh less than 10 pounds, but may occasionally weigh 20-30 pounds, within the building. 

Work Environment:

• The office and clinical areas are well illuminated, climate controlled, indoor areas. Work involves some exposure to hazards typical to a medical office environment, including potential exposure to infectious diseases and blood borne pathogens, chemical exposures, fire, mechanical and electrical hazards. Protective clothing and equipment are provided and required to be worn in potential exposure situations.

Qualified candidates are invited to submit a résumé in confidence for consideration.

J.L. Nick & Associates & MHEDS are equal opportunity employers.