What are the responsibilities and job description for the Billing Specialist position at Utah Partners for Health?
Description
The Billing Specialist is responsible for accurate and timely processing of patient billing within a Federally Qualified Health Center (FQHC) environment. This role supports the full revenue cycle, including charge entry, claim submission, payment posting, insurance follow-up, and patient account resolution. Experience with eClinicalWorks (eCW) and sliding fee scale processes is highly preferred.
Role and Responsibilities
- Accurately enter charges, review encounters, and ensure proper coding and documentation requirements are met.
- Prepare, submit, and monitor insurance claims (Medicaid, Medicare, commercial plans).
- Complete payment posting for insurance and patient payments, including bulk remittances.
- Identify and resolve billing errors, rejections, and denials; perform follow-up with payers as needed.
- Maintain familiarity with FQHC billing rules, including PPS, wrap payments, sliding fee scale, and eligibility verification.
- Communicate with patients regarding account questions, balances, and payment arrangements.
- Maintain accurate patient financial information, insurance coverage, and documentation according to compliance standards (HIPAA, HRSA, UDS).
- Collaborate with front desk, clinical staff, and finance teams to ensure accurate billing workflows.
- Generate reports and support month-end reconciliation as assigned.
- Other duties as assigned.
Requirements
Preferred Qualifications
- Experience with eClinicalWorks (eCW) practice management/EHR system.
- Knowledge of sliding fee programs and income verification processes.
- Prior FQHC or community health billing experience.
Qualifications and Education Requirements
- 2–3 years of medical billing, revenue cycle, or insurance claims experience.
- Strong knowledge of insurance plans, billing procedures, and payment posting.
- Bilingual (English/Spanish) required.
- High level of accuracy, attention to detail, and organizational skills.
- Ability to work both independently and collaboratively in a fast-paced environment.
- Strong communication and customer-service skills.
Skill & Competencies
- Ability to sit for long periods and work on a computer.
- Ability to maintain confidentiality and handle sensitive financial/health information.