Abrar Admin

Roots Community Health Center

<div>Description:

Position Summary:
The Senior Billing Specialist is responsible for accounts receivable follow-up, denial
management, and payment posting to maximize reimbursement and ensure timely
resolution of outstanding claims. This position focuses primarily on Alameda Alliance,
Medicare, and Medi-Cal claims and supports training of front desk staff, new hires, and
interns as needed. The position reports directly to the Billing Manager.
Duties and Responsibilities:<ul><li>
Review paper and electronic remittance advices (ERAs), explanation of benefits (EOBs), and denial notices.</li><li>
Post insurance payments and contractual adjustments accurately in AdvancedMD.</li><li>
Conduct accounts receivable follow-up on billed claims to ensure timely payment.</li><li>
Research denied or underpaid claims and take corrective action toward resolution.</li><li>
Correct claim errors and resubmit claims to payers as appropriate.</li><li>
Investigate payment delays and unresolved claims to maximize reimbursement.</li><li>
Review and update patient demographics, insurance plans, and carrier information.</li><li>
Verify insurance eligibility and PCP assignment when necessary.</li><li>
Maintain accurate demographic and insurance information in the electronic health record and billing system.</li><li>
Monitor and report denial trends and reimbursement issues to the Billing Manager.</li><li>
Participate in internal chart audits, billing audits, and compliance activities.</li><li>
Implement payer billing guidelines, policies, and procedures.</li><li>
Support front desk training as needed, including the development of tip sheets and desk references to assist the Patient Services Department.</li><li>
Assist with onboarding and training of new hires and interns as needed.</li><li>
Attend staff meetings, supervision sessions, and required trainings.</li><li>
Complete assigned documentation and reports in a timely manner.</li><li>
Perform other related duties as assigned.</li></ul>
Requirements:

Qualifications and Competencies:<ul><li>
High school diploma or equivalent required; Associate's or Bachelor's degree preferred.</li><li>
Minimum of three (3) years of experience in medical billing, payment posting, or accounts receivable follow-up.</li><li>
Experience working with Medicare, Medi-Cal, and managed care payers, including Alameda Alliance for Health.</li><li>
Strong knowledge of insurance denials, appeals, and payer billing guidelines.</li><li>
Proficiency in Electronic Health Records and practice management systems, preferably AdvancedMD.</li><li>
Knowledge of medical terminology and healthcare reimbursement principles.</li><li>
Strong analytical, organizational, and problem-solving skills.</li><li>
Ability to train and support staff in registration and billing-related workflows.</li><li>
Experience working in a nonprofit or community health center setting preferred.</li></ul></div>

Senior Billing Specialist

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Roots Community Health Center

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Senior Billing Specialist