Medical Billing Clerk

Founded in 1970, East Valley Community Health Center is a Federally Qualified Health Center (FQHC) who's services include providing personalized, affordable, high-quality medical, dental, vision and behavioral health care through a community-based network within the East San Gabriel Valley and Pomona Communities. Our staff practices patient-centered care by serving each patient with a personalized care plan that meets their individual needs. Our patients have access to support services that include, nutrition, health education, case management, pharmacy, lab, and x-ray at our health center locations. East Valley serves the health care needs of uninsured and underserved individuals and families throughout our 8 health center locations.

Our mission is to provide access to excellent health care while engaging and empowering our patients, employees, and partners to improve their well-being and the health of our communities.

P osition Summary

Under direct supervision of the Revenue Cycle Manager, Billing Clerk is responsible for accurate Billing of all outpatient services, procedures, diagnoses and conditions, working from the appropriate documentation in the Electronic Medical Record. Responsible for reviewing that process claims correspond to appropriate classification systems including ICD-10-CM, CPT, Healthcare Common Procedure Coding System (HCPCS) as well as other specialty systems as required by diagnostic category. All work is carried out in accordance with the rules, regulations and coding conventions of the ICD-10, Centers for Medicare and Medicaid (Medi-Cal) Services (CMS), Office of Statewide Health Planning and Development (OSHPD), Governmental Contractual requirements, Third Party Insurance and EVCHC coding guidelines. Billing Clerk will be responsible for payment posting, assigned collections, and face to face customer services. Manage assigned Work Edit Que’s, as well as, run hard copy paper claim as necessary.

Major Position Responsibilities and Functions

• Review patient chart documentation to assure correct coding and accurate billing. Process/ Enter accurate data into NexGen in a timely manner.
• Submit claims, Edits errors, and trouble shoots paper and/or electronically per carrier requirements in a timely manner. Clears errors per carrier receipt and re-submit. Trouble shoot correct and re-submit any claims returned by mail/electronically.
• Assist patients by answering questions regarding individual statements.
• On a daily basis, research claims unpaid status. Trouble-shoot and corrects to reduce AR balances.
• On a daily basis work the various Work Que’s (Charge Review, Claim Edit, Follow Up)
• Post payments to system associated with patients and insurance carrier’s remittance.
• Prepares and Process refund to patients and insurance carriers.
• Serve as a role model and mentor to staff, developing a positive team atmosphere within the department.
• Meet or exceed customer needs in a caring, effective and efficient manner.
• Maintain levels of quality that meet or exceed customer expectations through process improvement and a team-oriented approach.
• Other duties or projects as assigned.

Position Requirements and Qualifications

• HS Diploma or GED. Completion of classes in medical terminology, anatomy and physiology, ICD-10 and Current Procedural Terminology (CPT) coding conventions, and disease process from an accredited program.
• At least two (2) year billing experience in private or health care organization (preferred but not required); Experience with physician or ambulatory setting coding preferred. MediCal knowledge a plus.
• Strong computer skills and working knowledge of Microsoft Word and Excel software.
• Able to use health related Practice Management System.
• Ability and willingness to demonstrate and maintain competency as required for job title.
• Good organizational and communication skills.
• Bilingual (English and Spanish) highly preferred.
• Ability to multi-task and to consistently meet deadlines.
• Must be detail oriented and accurate.

East Valley offers defined contribution retirement plan and you will also enjoy work-life balance with paid time off and paid holidays throughout the year.

Please apply to this position with your current resume.

Principals only. Recruiters, please do not contact this job posting.

EOE is the Law. It is the stated policy of EVCHC to conform to all the laws, statutes, and regulations concerning equal employment opportunities and affirmative action. We strongly encourage women, minorities, individuals with disabilities and veterans to apply to all of our job openings. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, or national origin, age, disability status, Genetic Information & Testing, Family & Medical Leave, protected veteran status, or any other characteristic protected by law. We prohibit Retaliation against individuals who bring forth any complaint, orally or in writing, to the employer or the government, or against any individuals who assist or participate in the investigation of any complaint or otherwise oppose discrimination.