About Consolidated Tribal Health Project, Inc.

Consolidated Tribal Health Project, Inc. is a rural community health clinic that was incorporated as a 501 ( c )(3) in 1984 to address the disparity in health care among Native American people living in Mendocino County.

Our Mission

Consolidated Tribal Health Clinic, Inc. is committed to healthy lifestyles and honoring traditional Native American values to maintain physical, mental, emotional, spiritual and social wellbeing of the community.

POSITION: Billing Clerk III

DEPT: Finance

REPORTS TO: Billing Supervisor

FSLA STATUS: Non-exempt

SALARY RANGE: $41,808-$58,822

POSTITON SUMMARY: Reviews and verifies codes and supplies information to ensure compliance with established coding guidelines, third party reimbursement policies and federal and state regulations.

DUTIES AND RESPONSIBILITIES:

1. Proficient in FSI, Electronic Health Record, Accounts Receivable, Vista Imaging, electronic claims systems and other software.

2. Review billing packet to ensure all charges are billed correctly.

3. Enter and updates patient demographic information into computer system including any and all third party insurance.

4. Post all charges, adjustments, procedure codes and sliding fee to patient accounts from 3PB, Accounts Receivable and any other software.

5. Complete and processes all visits for revenue by any Third Party Payer.

6. Research and correct follow- up denials.

7. Enter dental procedures from dental progress notes into RPMS (Dental Data Systems Menu) and PCC Data Entry Module.

8. Complete all claim submission including all electronic and paper claims on a weekly basis including all secondary and tertiary claims.

9. Post all payments and maintain copies of payment batches according to the billing office processes.

10. Report problems of billing software to Supervisor.

11. Research and process credits on patient accounts.

12. Complete Medi-Cal and PHC CIF’s and appeals.

13. Assist patients with statements.

14. Verify address on return mail.

15. Assist Billing Clerk II with questions regarding issues with provider’s narrative, etc.

16. Serve as a back up to the Billing Supervisor.

17. Assist Fiscal Department to determine insurance and private pay payments as related to medical or dental.

18. Answer incoming phone calls regarding patient account balances and insurance and payment applications.

19. Cross-train in other areas of responsibility, as assigned by the Billing Supervisor.

20. Periodically attends seminars on billing and keeps informed of all current billing information.

21. Willingly performs other duties as assigned.

QUALIFICATIONS & REQUIREMENTS:

1. Associates Degree and/or three years’ experience equivalent education.

2. Demonstrated team lead or supervisory experience.

3. Three years’ experience in billing.

4. CCS, CCS-P or CPC Certification preferred.

5. Advance Knowledge of medical terminology, anatomy, physiology.

6. Working knowledge of medical and dental billing and coding guidelines within the federal and state regulations (i.e. Medicare and Medi-Cal guidelines).

7. Requires skill and knowledge in the use of a wide variety of office equipment and software including: computers, calculator (10-key), facsimile, copy machine, printer and other office equipment as required. Software to include: Microsoft Office (Word and Excel) and email.

8. Basic knowledge of Electronic Health Record and willingness to learn CTHP billing processes.

9. Knowledge of regulations regarding confidentiality in the workplace, such as HIPAA regulations.

10. Ability to follow instruction and work independently.

11. Ability and willingness to participate as a member of a team, within the department and within the organization.

INDIAN PREFERENCE: Preference in filling vacancies will be given to qualified Indian candidates, in

accordance with the Indian Preference Act (Title 25, U.S. Code, Section 472 and 473). In other than the above, CTHP is an equal opportunity, affirmative action employer, and does not discriminate in employment decisions based on race, color, religion, gender, national origin, age disability or sexual orientation.

NOTICE OF DRUG-FREE WORKPLACE ACT REQUIREMENT: CTHP is required to implement the Drug-Free Workplace Act of 1988, 45 CFR Part 76, Subpart F. As such, it is unlawful for employees to manufacture, distribute, dispense, possess, or use a controlled substance on the job site. Employees who are reasonably suspected of violating this act may be subject to drug testing as a condition of employment. Employer required fitness examinations shall include drug testing as evidence of employee and employer compliance with the Drug-Free Workplace Act.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is frequently required to stand and/or smell. The employee is occasionally required to walk; sit and climb or balance. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, peripheral vision and depth perception.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually average.

Job Type: Full-time

Pay: $41,808.00 - $58,822.00 per year

Benefits:

• 401(k)
• AD&D insurance
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid sick time
• Paid time off
• Retirement plan
• Vision insurance

Experience level:

• 3 years

Physical setting:

• Office

Schedule:

• 8 hour shift
• Monday to Friday

People with a criminal record are encouraged to apply

Education:

• Associate (Required)

Experience:

• Medical billing: 3 years (Preferred)

License/Certification:

• CCS, CCS-P or CPC Certification (Required)

Ability to Commute:

• Redwood Valley, CA 95470 (Required)

Ability to Relocate:

• Redwood Valley, CA 95470: Relocate before starting work (Required)

Work Location: In person