Billing Specialist

Description

OUR MISSION

Wellness Equity Alliance (WEA) Is a Novel National Public Health Organization Comprised Of a Multidisciplinary Team Of Population And Public Health Experts With Backgrounds In Infectious Disease, Public Health, Emergency Medicine, Primary Care, Cardiology, Pediatrics, Psychiatry, Community Health Work (CHW), Nursing And Advanced Practice Pharmacy. We Work Nearly Exclusively With Underrepresented Communities, Fundamentally Addressing Health-care Disparities And The Social Determinants Of Health (SDoH) That Have Been Amplified During The COVID-19 Pandemic, Prioritizing The Following

• People experiencing homelessness
• Indigenous communities
• Immigrant communities
• Rural communities
• BIPoC communities
• LGBTQIA communities
• Justice-impacted communities
  
  

The WEA team is diverse, inclusive, and nimble enough to assemble teams of healthcare professionals within days using our proven local staff recruitment models to address population health crises and communicable disease outbreaks. The WEA team’s partnership model is collaborative and allows hospitals, health jurisdictions, state/local government agencies to provide timely care using equity-based strategies for individuals and marginalized communities.

Purpose of the position

The Billing Specialist supports accurate and timely revenue cycle operations for outpatient services, ensuring compliant charge capture, claim submission, and reimbursement. This role partners closely with clinical, administrative, and payer stakeholders to resolve billing issues, reduce denials, and improve overall financial performance—while supporting equitable access to care through efficient, patient-centered billing practices.

Key Highlights

• Compensation Range: $22.11 - 27.40 an hour, with final compensation determined based on experience, qualifications, and role scope.
• Work Location & Expectations: This role requires daily in-person engagement at our Indio CWI location.
• Professional Development: Opportunity to collaborate with cross-functional leaders across Behavioral Health, Medical, Street Medicine, Public Health, Rural Health, and Tribal Health initiatives.
  
  

Key Responsibilities

Core Billing & Claims

• Prepare, review, and submit outpatient claims (professional and/or facility) to commercial, Medicaid/Medi-Cal, and Medicare payers.
• Ensure accurate coding alignment (CPT, HCPCS, ICD-10) and charge entry based on clinical documentation.
• Monitor claim status and follow up on unpaid or denied claims in a timely manner.
  
  

Denials & A/R Management

• Investigate and resolve claim denials, rejections, and underpayments.
• Work assigned accounts receivable (A/R) queues to meet productivity and aging targets.
• Identify root causes of denials and escalate trends to leadership with recommendations.
  
  

Compliance & Accuracy

• Maintain compliance with payer guidelines, regulatory requirements, and organizational policies.
• Support internal and external audits by ensuring documentation and billing accuracy.
• Stay current on billing rules, payer updates, and coding changes.
  
  

Cross-Functional Collaboration

• Partner with front desk, clinical teams, and coding staff to resolve charge discrepancies.
• Communicate with payers and patients to clarify billing issues or missing information.
• Contribute to workflow improvements that enhance billing efficiency and patient experience.
  
  

Reporting & Process Improvement

• Track key billing metrics (clean claim rate, denial rate, days in A/R).
• Recommend process improvements to reduce errors and accelerate reimbursement.
• Support implementation of new billing tools, workflows, or payer requirements.
  
  

Requirements

Qualifications and Education Requirements

• High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
• 2–4 years of outpatient medical billing experience (clinic, FQHC, or hospital outpatient preferred).
• Experience with Medi-Cal/Medicaid, Medicare, and commercial payer billing.
• Working knowledge of CPT, ICD-10, and HCPCS coding as it relates to billing.
• Familiarity with EHR/PM systems (e.g., Athena, Epic, NextGen, eClinicalWorks, or similar).
  
  

Preferred Skills

• Certification (e.g., CPC, CPB through AAPC or equivalent).
• Experience in multi-site or high-volume outpatient environments.
• Background in behavioral health, public health, or community-based care settings.