Medical Billing Specialist

Fair Haven Community Health Care 

FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at nearly 140,000 office visits in 19 locations. Overseen by a Board of Directors, the majority of whom are patients themselves, we are proud to offer a wide range of primary and specialty care services, as well as evidence-based patient programs to educate patients in healthy lifestyle choices. As we grow and are able to bring high-quality health care to more areas that need access, we continue to put our patients first in everything we do. The mission of FHCHC is “To improve the health and social well-being of the communities we serve through equitable, high quality, patient-centered care that is culturally responsive.”

For over 50 years, we have been a health care leader in our community focused on providing excellent, affordable primary care to all patients, regardless of insurance status or ability to pay. Fair Haven is proud to have a diverse and motivated team of professionals who are constantly seeking ways to enhance and improve the health and well-being of all patients. We believe that everyone should have access to high-quality medical and dental care, regardless of ability to pay.

Job purpose

Responsible for maintaining the professional reimbursement program. Ensure compliance with current payments and rules that impact billing and collection. Follow-up of any outstanding A/R  all-payers, self-pay, and the resolution of denials.  Manage correspondence.

Duties and responsibilities

• Performs billing and computer functions, including patient & thirds party billing, data entry and posting encounters.
• Prepares and submits clean claims to various insurance companies either electronically or by paper.
• Handle the follow-up of outstanding A/R all-payers, including self-pay and /or the resolution of denials. 
• Answers question from patients, FHCHC staff and insurance companies.
• Identifies and resolves patient billing complaints.
• Prepares reviews and send patient statements.
• Handle all correspondence related to insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get the maximum payments and accounts and identify issues or changes to achieve client profitability.
• Take call from patients and insurance companies regarding billing and statement questions.
• Process and post all patient and/or insurance payments. 

Qualifications

• High School diploma or GED with experience in medical billing
• Knowledge of third party billing requirements, ICD and CPT codes
• Needs good interpersonal skills and ability to work as a member of the team to serve the patients.
• Accurate & detail oriented
• Ability to work independently
• Bi-lingual in English and Spanish Preferred

Technical Qualifications

• Ability to use computer and multi-lined telephones
• Understanding of billing practice
• Oral and written Proficiency in English

Direct reports

None

OSHA Status

Category III—Low Risk Position

Generally works in an office environment with no exposure to bloodborne pathogens

 Physical requirements

Physical Demands: Requires walking, bending, sitting, standing, writing, reading, telephone use, data input into computer, pulling medical records,

Mental Demands: Ability to cope with continual changing priorities under potentially stressful conditions

Manual Dexterity Required:  Ability to use a keyboard, telephone.

American with Disabilities Requirements:

External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.

Fair Haven Community Health Care is an Equal Opportunity Employer. FHCHC does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.