Billing Specialist jobs at Women's Care

Come Join the Premier Infusion & Healthcare Family! At Premier we offer employees stability and opportunities for advancement. Our commitment to our core values of Compassion, Integrity, Respect and Excellence in People applies to our employees, our customers, and the communities we serve. This is a rewarding place to work! Premier Infusion and Healthcare Services is a preferred post-acute care partner for hospitals, physicians and families in Southern CA. Our rapidly growing home health and infusion services deliver high-quality, cost-effective care that empowers patients to manage their health at home. Customers choose Premier Infusion and Healthcare Services because we are united by a single, shared purpose: We are committed to bettering the quality of life for our patients. This is not only our stated mission but is what truly drives us each and every day. We believe that our greatest competitive advantage, our greatest asset are our employees, our Premier Family in and out of the office sets Premier apart. PREMIER BENEFITS - For FULL TIME Employees: ● Competitive Pay ● 401K Matching Plan - Up to 4% ● Quarterly Bonus Opportunities ● Medical, Dental & Vision Insurance ● Employer Paid Life Insurance ● Short Term / Long Term Disability Insurance ● Paid Vacation Time Off ● Paid Holidays ● Referral Incentives ● Employee Assistance Programs ● Employee Discounts ● Fun Company Events JOB DESCRIPTION: BILLER Description of Responsibilities Coordinates and performs business office activities involved with collecting payments for Premier Infusion Care products and follows established procedures for billing. Reporting Relationship Billing Manager Scope of Supervision None Responsibilities include the following: 1. Performs all aspects of billing for commercial insurance companies/ health plans, medical groups, hospitals, hospice facilities, NCPDP, and/or MSO's 2. Bills Medicare for PR-96/204 (denials) required for secondary billing submissions. 3. Follows up on EOB's (explanation of benefits) which includes: - Medicare denials - Billing secondary insurance after Medicare's has denied claims. 4. Calling insurance companies for explanation of denials if questionable. 5. Making corrections on deny claims and re-bills insurance companies. 6. Checks EOB's with contracted fee schedule for accuracy or adjustments as needed. 7. Patient calls for benefit, invoicing, and explanations as needed. 8. Resolves electronic (Office Ally, Novologix, or Emdeon clearing house) report matters. Minimum Qualifications: Effective interpersonal, time management and organizational skills. Office experience preferred. Computer skills that include word processing, and efficient use of the internet and e-mail. Must possess excellent oral and written communication skills, with the ability to express technical issues in “layman” terms. Must be detail oriented Education and/or Experience: Must have a High School diploma or Graduation Equivalent Diploma (G.E.D.) or Higher. At least 1 -2 years of medical or pharmaceutical billing experience or related A/R Knowledge of insurance verification procedures. Proficiency in 10-key preferred. Prior experience in a pharmacy or home health company is of benefit. Prior experience in a consumer related business is also of benefit. Equal Employment Opportunity (EEO) It is the policy of Premier Infusion & Healthcare Services to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Premier Infusion & Healthcare Services will provide reasonable accommodations for qualified individuals with disabilities. Job Type: Full-time Work Location: In person

Come Join the Premier Infusion & Healthcare Family! At Premier we offer employees stability and opportunities for advancement. Our commitment to our core values of Compassion, Integrity, Respect and Excellence in People applies to our employees, our customers, and the communities we serve. This is a rewarding place to work! Premier Infusion and Healthcare Services is a preferred post-acute care partner for hospitals, physicians and families in Southern CA. Our rapidly growing home health and infusion services deliver high-quality, cost-effective care that empowers patients to manage their health at home. Customers choose Premier Infusion and Healthcare Services because we are united by a single, shared purpose: We are committed to bettering the quality of life for our patients. This is not only our stated mission but is what truly drives us each and every day. We believe that our greatest competitive advantage, our greatest asset are our employees, our Premier Family in and out of the office sets Premier apart. PREMIER BENEFITS - For FULL TIME Employees: ● Competitive Pay ● 401K Matching Plan - Up to 4% ● Quarterly Bonus Opportunities ● Medical, Dental & Vision Insurance ● Employer Paid Life Insurance ● Short Term / Long Term Disability Insurance ● Paid Vacation Time Off ● Paid Holidays ● Referral Incentives ● Employee Assistance Programs ● Employee Discounts ● Fun Company Events JOB DESCRIPTION: Description of Responsibilities The Insurance Coordinator is responsible for all new referral insurance verification and/or authorization in a timely matter. Reporting Relationship Insurance Manager Responsibilities include the following: Responsible for insurance verification and/or authorization on patients. Responsible for audit of information from the Intake Referral Form and patient information received from the referral source entered into the computer system correctly. This includes but is not limited to: demographics, insurance, physician, nursing agency, diagnosis, height, weight, and allergies (when information is available and as applicable). Re-verification of verification and/or authorization and demographics on all patients. Participate in surveys conducted by authorized inspection agencies. Participate in in-service education programs provided by the pharmacy. Report any misconduct, suspicious or unethical activities to the Compliance Officer. Perform other duties as assigned by supervisor. Minimum Qualifications: Must possess excellent oral and written communication skills, with the ability to express technical issues in “layman” terms. Fluency in a second language is a plus. Must be friendly professional and cooperative with a good aptitude for customer service and problem solving. Education and/or Experience: Must have a High School diploma or Graduation Equivalent Diploma (G.E.D.) Prior experience in a pharmacy or home health company is preferred. Prior dental or home infusion experience a plus Prior experience in a consumer related business is preferred Equal Employment Opportunity (EEO) It is the policy of Premier Infusion & HealthCare Services to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Premier Infusion & HealthCare Services will provide reasonable accommodations for qualified individuals with disabilities.

The RCM OPEX Specialist plays a critical role in optimizing the financial performance of healthcare organizations by ensuring that revenue cycle management processes are efficient and compliant with industry regulations. This position requires detail-oriented professionals who can navigate complex insurance claims and reimbursement processes. Essential Job Functions Manage internal and external customer communications to maximize collections and reimbursements. Analyze revenue cycle data to identify trends and proactively remediate suboptimal processes. Maintain fee schedule uploads in financial and practice operating systems. Review and resolve escalations on denied and unpaid claims. Collaborate with healthcare providers, payors, and business partners to ensure revenue best practices are promoted. Monitor accounts receivable and expedite the recovery of outstanding payments. Prepare regular reports on refunds, under/over payments. Stay updated on changes in healthcare regulations and coding guidelines. *NOTE: The list of tasks is illustrative only and is not a comprehensive list of all functions and tasks performed by this position. Other Essential Tasks/Responsibilities/Abilities Must be consistent with Femwell's core values. Excellent verbal and written communication skills. Professional and tactful interpersonal skills with the ability to interact with a variety of personalities. Excellent organizational skills and attention to detail. Excellent time management skills with proven ability to meet deadlines and work under pressure. Ability to manage and prioritize multiple projects and tasks efficiently. Must demonstrate commitment to high professional ethical standards and a diverse workplace. Must have excellent listening skills. Must have the ability to maintain reasonably regular, punctual attendance consistent with the ADA, FMLA, and other federal, state, and local standards and organization attendance policies and procedures. Must maintain compliance with all personnel policies and procedures. Must be self-disciplined, organized, and able to effectively coordinate and collaborate with team members. Extremely proficient with Microsoft Office Suite or related software; as well as Excel, PPT, Internet, Cloud, Forums, Google, and other business tools required for this position. Education, Experience, Skills, and Requirements Bachelor's degree preferred. Minimum of 2 years of experience in medical billing, coding, revenue cycle or practice management. Strong knowledge of healthcare regulations and insurance processes. Knowledgeable in change control. Proficiency with healthcare billing software and electronic health records (EHR). Knowledge of HIPAA Security preferred. Hybrid rotation schedule and/or onsite as needed. Medical coding (ICD-10, CPT, HCPCS) Claims management (X12) Revenue cycle management Denials management Insurance verification Data analysis Compliance knowledge Comprehensive understanding of provider reimbursement methodologies Billing software proficiency

1/6/2025 - Minor revision. No need to reapply . The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in its workforce. All employees at the Department of Public Health work to advance equity, inclusion, and diversity with a specific lens and focus on race, ethnicity, gender, sex, sexuality, disability, and immigration status. ✅ START with this Required Assessment forms.gle/pL5Nj3BE61ewXNmo6 Salary : careers.sf.gov/classifications/?class Code=2233 Appointment Type : Permanent Civil Service Recruitment ID : CCT-2233-H00001 Positions may be available in a variety of settings including Zuckerberg San Francisco General Hospital, Laguna Honda Hospital, and community-centered outpatient clinics within the Health Network. Positions may also be in the Population Health Division's public health leadership, with a focus on programs to ensure the health and wellbeing of all San Franciscans. The Mission of the San Francisco Department of Public Health (SFDPH) is to protect and promote the health of all San Franciscans. SFDPH strives to achieve its mission through the work of multiple divisions - the San Francisco Health Network, Population Health, Behavioral Health Services, and Administration. The San Francisco Health Network is the City's only complete system of care and has locations throughout the City, including Zuckerberg San Francisco General Hospital and Trauma Center, Laguna Honda Hospital and Rehabilitation Center, and over 15 primary care health centers. The Population Health Division (PHD) provides core public health services for the City and County of San Francisco: health protection, health promotion, disease and injury prevention, and disaster preparedness and response. Behavioral Health Services operates in conjunction with SFHN and provides a range of mental health and substance use treatment services. Job Description Common Duties Include Directs and has overall responsibility for the functioning of a clinic, center, program, or other patient care site, including the assignment and supervision of physician specialists, other health professionals, and other staff members. Plans and directs medical staff development and in-service training activities at the facility, division, or program; conducts staff meetings and conferences. Conducts meetings with agency heads and representatives; consults with other agencies on problems and programs; evaluates community needs for specialized services and plans accordingly. Provides medical treatment to patient population of focus; provides treatment and guidance of treatment of particularly difficult and complicated cases and evaluates facility, division, or program operations and efficiency. Develops and manages a budget for a clinic or program. Division Duties Include Population Health Division Directs and has overall responsibility for citywide public health functions in the Population Health Division, including the work of specialized branches and sections Develops and supports leaders within their direct reporting structure to strengthen a diverse workforce and achieve citywide public health goals Develops relationships to facilitate alignment and effective communication with internal and external stakeholders Represents the work of PHD to internal and external partners and stakeholders. Develops and manages budgets for their areas of work in partnership with PHD leadership Primary Care Overseeing clinic operations in a variety of community-based clinics Qualifications MINIMUM QUALIFICATIONS Possession of a valid license to practice medicine issued by the Medical Board of California or the Osteopathic Medical Board of California* AND Possession of valid Board Certification in the appropriate medical specialty area for the assigned facility or division AND Three (3) years of post-residency experience as a practicing physician in the respective medical specialty area. One (1) year of full-time employment is equivalent to 2,000 hours (2,000 hours of qualifying work experience is based on a forty (40) hour work week). *Applicants possessing a valid license to practice medicine issued from another state within the United States of America may apply, but if selected, the candidate will NOT be appointed/hired until they obtain a valid license to practice medicine issued by the Medical Board of California or the Osteopathic Medical Board of California. For some positions, possession of valid Drug Enforcement Agency registration with the United States Department of Justice is a special condition that is required in addition to the standard minimum qualifications associated with this job classification. Conditions of Employment All qualified candidates who have been selected for appointment to positions in all specialty areas must be an eligible billable provider and must meet the following criteria within two (2) weeks prior to the start work date to avoid delay of the appointment to the position and/or cancellation of an employment offer: All qualified candidates who have been selected for appointment to positions in all specialty areas must be an eligible billable provider and will be required to meet all of the following criteria: Be eligible to participate in Medicare, Medicaid, and/or other federal healthcare programs Possess a National Provider Identifier (NPI) Submit a completed credentialing application and/or required documentation for credentialing Possess a valid third-party billable provider certification (such as Medicare, Medi-Cal, and/or private insurance) OR have submitted a completed billable provider application, along with the required documentation, in order to obtain the appropriate billable provider status Important Note: Please make sure it is absolutely clear in your application exactly how you meet the minimum qualifications. Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. Please be aware that any misrepresentation of this information may disqualify you from this recruitment or future job opportunities. Additional Information SELECTION PROCEDURES Training and Experience Assessment (Weight 100%) The Required Assessment inked in this job ad is designed to measure knowledge, skills, and/or abilities in job-related areas which may include, but are not limited to experience: Working with vulnerable patient populations Supervising clinical and administrative professionals Improving clinical quality Engaging patients and improving their experience Engaging staff and improving their experience Participating in quality assurance activities Once submitted, applicant responses on the Required Assessment cannot be changed. Qualified applicants must achieve a passing score in order to be ranked on the eligible list/score report. Successful applicants will be placed on the eligible list/score report, in rank order, according to their final score. Certification The certification rule for the eligible list resulting from this assessment will be the Rule of the List. Additional selection processes may be conducted by the hiring department prior to making final hiring decisions. Eligible List/Score Report Once you pass the assessment, you will be placed on an eligible list and given a score and a rank. For more information, visit ****************************************** Candidate names will remain on the list for a maximum period of 12 months. Unselected candidates may reapply after their eligibility expires. How to Apply Applications for City and County of San Francisco jobs are only accepted through an online process. Visit careers.sf.gov and begin the application process. Our email communications may come from more than one department, so please make sure your email is set to accept messages from all of us at sfdhr.org/ccsf-email-extensions . Applicants may be contacted by email about this recruitment; therefore, it is their responsibility to contact the Analyst if they update their email address. Applicants will receive a confirmation email that their online application has been received in response to every announcement for which they file. Applicants should retain this confirmation email for their records. Failure to receive this email means that the online application was not submitted or received. Terms of Announcement and Appeal Rights Applicants must be guided solely by the provisions of this announcement, including requirements, time periods and other particulars, except when superseded by federal, state or local laws, rules or regulations. The correction of clerical errors in an announcement may be posted on the Department of Human Resources website at *********************** . The terms of this announcement may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department of Human Resources, 1 S Van Ness Avenue, 4th Floor, San Francisco, CA 94103-5413 by close of business on the 5th business day following the issuance date of this examination announcement. Information concerning other Civil Service Commission Rules involving announcements, applications and examination policies, including applicant appeal rights, can be found on the Civil Service Commission website at *********************************** . Additional information regarding Employment with the City and County of San Francisco: Information about the Hiring Process Conviction History Employee Benefits Overview Equal Employment Opportunity Disaster Service Workers Reasonable Accommodation Right to Work Copies of Application Documents Diversity Statement Veterans Preference Seniority Credit in Promotional Exams If you have any questions regarding this recruitment or application process, please contact the assessment analyst, [email protected] ************. We may use text messaging to communicate with you on the phone number provided in your application. The first message will ask you to opt in to text messaging. The City and County of San Francisco encourages women, minorities and persons with disabilities to apply. Applicants will be considered regardless of their sex, race, age, religion, color, national origin, ancestry, physical disability, mental disability, medical condition (associated with cancer, a history of cancer, or genetic characteristics), HIV/AIDS status, genetic information, marital status, sexual orientation, gender, gender identity, gender expression, military and veteran status, or other protected category under the law.

2/19/2025 - Minor revision. No need to reapply . The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in its workforce. All employees at the Department of Public Health work to advance equity, inclusion, and diversity with a specific lens and focus on race, ethnicity, gender, sex, sexuality, disability, and immigration status. The San Francisco Department of Public Health continuously accepts applications for all Physician Specialist positions. Salary : ********************************************* Code=2230 Appointment Type : Temporary Exempt or Permanent Exempt Positions may be available in a variety of settings including Zuckerberg San Francisco General Hospital, Laguna Honda Hospital, and community-centered outpatient clinics within the Health Network. These positions include full-time permanent, part-time permanent, and part-time as needed. The Mission of the San Francisco Department of Public Health (SFDPH) is to protect and promote the health of all San Franciscans. SFDPH strives to achieve its mission through the work of multiple divisions - the San Francisco Health Network, Population Health, Behavioral Health Services, and Administration. The San Francisco Health Network is the City's only complete system of care and has locations throughout the City, including Zuckerberg San Francisco General Hospital and Trauma Center, Laguna Honda Hospital and Rehabilitation Center, and over 15 primary care health centers. The Population Health Division (PHD) provides core public health services for the City and County of San Francisco: health protection, health promotion, disease and injury prevention, and disaster preparedness and response. Behavioral Health Services operates in conjunction with SFHN and provides a range of mental health and substance use treatment services. Job Description Duties Include Family physician, internist or medical subspecialist Evaluates patient signs and symptoms, reviews laboratory and radiological data, diagnoses complex cases, and institutes treatments as appropriate. May serve as a consultant to other physicians, including specialists in other fields. Surgical specialist or subspecialist Evaluates patient signs and symptoms, reviews laboratory and radiological data, recommends, performs, and consults on specialized surgical procedures within his or her specialty field. Pediatrician Examines, diagnoses, and treats pediatric patients; refers to other physicians, clinics, and agencies when so indicated. Obstetrician/gynecologist Provides obstetrical and gynecological care including screening, diagnosis, treatment, prenatal and obstetrical care. Specialist in occupational health Conducts pre-employment physical examinations of candidates for city service; when designated by the Civil Service Commission, assesses medical or physical competence of staff to perform assigned duties; participates in the identification and assessment of occupational hazards and injuries; develops and implements preventive and educational strategies. Qualifications MINIMUM QUALIFICATIONS Possession of a valid license to practice medicine issued by the Medical Board of California or the Osteopathic Medical Board of California* AND Successful completion** of a residency program accredited by the Accreditation Council for Graduate Medical Education or American Osteopathic Association in the appropriate medical specialty area for the assigned facility or division (i.e., Board Eligible) *Applicants possessing a valid license to practice medicine issued from another state within the United States of America may apply, but if selected, the candidate will NOT be appointed/hired until they obtain a valid license to practice medicine issued by the Medical Board of California or the Osteopathic Medical Board of California. **Applicants enrolled in a residency program may apply, but if selected, the candidate will NOT be appointed/hired until they demonstrate successful completion of a residency program accredited by the Accreditation Council for Graduate Medical Education or American Osteopathic Association in the appropriate medical specialty area for the assigned facility. For some positions, possession of valid Drug Enforcement Agency registration with the United States Department of Justice is a special condition that is required in addition to the standard minimum qualifications associated with this job classification. Conditions of Employment All qualified candidates who have been selected for appointment to positions in all specialty areas must be an eligible billable provider and must meet the following criteria within two (2) weeks prior to the start work date to avoid delay of the appointment to the position and/or cancellation of an employment offer: Be eligible to participate in Medicare, Medicaid and/or other federal health care programs; Possess a National Provider Identifier (NPI); Submit a completed credentialing application and/or required documentation for credentialing; AND Possess a valid third-party billable provider certification (such as Medicare, Medi-Cal and/or private insurance) OR have submitted a completed billable provider application, along with the required documentation, in order to obtain the appropriate billable provider status. Important Note: Please make sure it is absolutely clear in your application exactly how you meet the minimum qualifications. Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. Please be aware that any misrepresentation of this information may disqualify you from this recruitment or future job opportunities. Additional Information How to Apply Applications for City and County of San Francisco jobs are only accepted through an online process. Visit careers.sf.gov and begin the application process. Our email communications may come from more than one department, so please make sure your email is set to accept messages from all of us at sfdhr.org/ccsf-email-extensions . Applicants may be contacted by email about this recruitment; therefore, it is their responsibility to contact the Analyst if they update their email address. Applicants will receive a confirmation email that their online application has been received in response to every announcement for which they file. Applicants should retain this confirmation email for their records. Failure to receive this email means that the online application was not submitted or received. Additional information regarding employment with the City and County of San Francisco: Information about the Hiring Process Conviction History Employee Benefits Overview Equal Employment Opportunity Disaster Service Workers Reasonable Accommodation Right to Work Copies of Application Documents Diversity Statement If you have any questions regarding this recruitment or application process, please contact the exam analyst, [email protected] ************. We may use text messaging to communicate with you on the phone number provided in your application. The first message will ask you to opt in to text messaging. The City and County of San Francisco encourages women, minorities and persons with disabilities to apply. Applicants will be considered regardless of their sex, race, age, religion, color, national origin, ancestry, physical disability, mental disability, medical condition (associated with cancer, a history of cancer, or genetic characteristics), HIV/AIDS status, genetic information, marital status, sexual orientation, gender, gender identity, gender expression, military and veteran status, or other protected category under the law.

BILLING SPECIALIST II HYBRID RESPONSIBLE TO: Business Office Manager SALARY: Step Range: 12 ($40,453 annually) - 31 ($70,934 annually); Full Benefits CLASSIFICATION: Non-Management, Regular, Full-Time LOCATION: Hybrid - Up to 80% Remote / 20% In Office after initial year of training period Klamath Tribal Health & Family Services 3949 S. 6th Street, Klamath Falls, Oregon BACKGROUND: Comprehensive POSITION OBJECTIVE Klamath Tribal Health & Family Services (KTHFS) is a tribally operated health facility offering direct medical, dental, pharmacy, behavioral health, and non-emergent transportation services to American Indians and Alaska Natives residing within the service delivery area. The Billing Specialist II is responsible for managing patient accounts in a complex, multi-disciplinary Business Office environment. The incumbent shall cross-train with other members of the Business Office and shall participate in all functions of the coding and billing cycle, to include: daily review of encounters, analyzing chart notes and assuring the appropriate service codes are utilized, data entry of encounter forms, posting charges into the computer system, perform claims review, claims submission, timely billing, follow-up and collection of all accounts, payment posting, claims audit and research. The incumbent shall also function as a resource for clinic providers and staff and will assist with coding and billing questions, and quality assurance activities. MAJOR DUTIES AND RESPONSIBILITIES 1. Daily review, analyze, and interpret patient ambulatory EHR and/or paper encounter coding and corresponding chart note documentation and determine that the appropriate diagnostic and procedural codes are used and appropriately reflected in the chart note for code assignment as outlined by the CMS guidelines. Assuring that medical necessity billing guidelines are met. 2. Ensure that the appropriate service codes are applied in the billing record that corresponds to the documentation referenced in the chart note or on the encounter forms. Ensure that the appropriate ICD-X, CPT, HCPCS, CDT coding conventions have been used for services provided by all health service types within KTHFS. 3. Work with providers, nursing staff, and the business office to clarify documentation in the EHR system if needed. Including correlating anatomical and physiological processes of a diagnosis to assure the most accurate and specified ICD-X code(s) are used. Advise manager and clinicians of deficiencies to support charge capture of all billable services. 4. Prepare and submit clean claims (electronic or paper) to primary/secondary insurance carriers including Medicaid, Medicare, (Part A&B), and private insurance companies. 5. Maintain compliance with billing regulations: including Medicaid , Medicare (Parts A&B, DME), and private Insurance Carriers. 6. Payment post insurance checks or EFTs, which includes: verifying the checks or EFTs that have been receipted in the Master Check's & EFT's Microsoft spreadsheet, batching the checks or EFTs into NextGen and then accurately posting the payments. 7. Process refunds for any overpayments made to KTHFS. Monitor claims payment and promptly request POs for refunds to insurance companies, or perform electronic claim adjustments per payer requirements, for any overpayments made on claims. The refund will also be processed to reflect the refunded claim in NextGen. 8. Process No-Pay EOBs by applying an adjustment and creating billing and claim follow-up notes. This includes the appeal of insurance claims that have been wrongfully paid or denied, contacting insurance companies by phone to obtain information concerning extent of benefits and/or settle unpaid claims and providing any additional information requested by insurance companies for the processing of submitted claims. 9. Record in NextGen system all claims related phone calls, correspondence, and activities related to each patient account. 10. Maintain current filing system for encounters, POs, etc., process daily incoming mail and correspondence for review, completion, and filing. 11. Communicate regularly with Patient Registration and record patient benefit effective/term date(s) into the practice management system as needed. 12. Create electronic batches to submit to the clearinghouse and reconcile with the submitted claims tracking spreadsheet including follow up on electronic claims receipt by payer. Correct any claims before archiving the file in the clearinghouse. 13. Work outstanding A/R by reviewing, rebilling, and adjusting accounts to ensure accurate and thorough billing of claims, by running reports and working on claims. Track and monitor claims processing, ensure timely follow-up for the payment of bills; Identify, and resolve all outstanding/pending claims. 14. Monitor the Business Office outlook inbox regularly and back bill any claims and/or adjust claims where applicable. 15. Run specific reports as identified below: · To be run and worked weekly - Pending Charges Report, Unbilled and Rebilled Encounters, Paper Claims printed, Clearinghouse Reports (claims denied, outstanding claims, claims removed, claims rejected) · Biweekly reports - Kept Appointments with No Encounters report, Aging Reports, and maintaining up to date reports making sure all old billing is addressed. 16. Establish and maintain an effective working relationship with public and private payers; identify potential problems that could cause interruptions to cash flow. 17. Participate in yearly chart audit activities for quality assurance purposes; document results in report format, as needed, for review by the Chief Medical Officer and the Chief Quality Officer. 18. Attend coding seminars, meetings, or other training opportunities to keep abreast of changes in the profession. 19. Like all employees of the Klamath Tribes, the incumbent will be called upon to accomplish other tasks that may not be directly related to this position, but are integral to the Klamath Tribes' broader functions, including but not limited to, assisting during Tribal sponsored cultural, traditional, or community events that enable the successful operation of programs and practices of The Klamath Tribes as aligned with The Klamath Tribes' Mission Statement. Some of these tasks may be scheduled outside of regular work hours, if necessary. SUPERVISORY CONTROLS Work under the supervision of the Business Office Manager, who provides general instructions. Work is assigned in terms of functional/organizational objectives. The manager assists with unusual situations that do not have clear precedents. Employees must be able to work with minimal supervision, using initiative and judgement in setting priorities to meet the demands of the workload. Work is performed within the purview of laws, and regulations. The manager will review work regularly for quality and compliance with established policies and procedures and payer guidelines. KNOWLEDGE, SKILLS, ABILITIES Technical knowledge, skill, and understanding of the American Medical Association developed CPT coding system to acquire, interpret, and resolve problems based on information derived from system monitoring reports to be carried over to the required billing forms. Technical knowledge, skill, and understanding of the concepts of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-X-CM) for classification of diseases and/or procedures. Knowledge and understanding of CDT dental coding system. Basic knowledge and understanding of HCPCS coding. Knowledge of mental health and alcohol and drug coding and billing is desirable. Ability to work with minimal supervision, using initiative and judgment in setting priorities to meet the demands of the workload while adhering to the insurance rules and regulations that relate to coding and billing. The knowledge of and/or the ability to learn the billing guidelines as they pertain to FQHC/Tribal Health Clinics. Knowledge of established procedures required claim forms (both paper and electronic) associated with the various health insurance programs. In-depth knowledge of Medicaid (OARs, Rulebooks). In-depth knowledge of Medicare Part A & B billing regulations. Knowledge of medical terminology. Knowledge of claims review, account auditing, and quality assurance. The ability of tracking, handling, and completing multiple projects. Ability to communicate well (both orally and in writing) and work effectively with other employees, managers, and administrators. This person should be able to express themselves in a clear and concise manner for the purposes of correspondence, reports and instructions, as well as for obtaining and conveying information to ensure a cooperative working relationship with all staff. Willingness to maintain expertise to keep current with changes in procedure and diagnosis coding and third-party payer reimbursement policies through continuing education. Above average ability to work with numbers and set standards to assure proper payment and adjustment posting. Must be dependable, thorough, accurate, well-organized and detail oriented. Ability to maintain strict confidentiality of medical records and adhere to the standards for health record-keeping, HIPAA and Privacy Act requirements. Conduct self in accordance with KTH&FS Employee Policy & Procedure Manual. QUALIFICATIONS, EXPERIENCE, EDUCATION Minimum Qualifications: Failure to comply with minimum position requirements may result in termination of employment. · REQUIRED Onsite training/working for the first year upon hire may be required. Up to 80% of remote work after training requirements are completed subject to business needs and management approval. · REQUIRED to possess a High School Diploma or Equivalent. ( Must submit a copy of diploma or transcripts with application.) · REQUIRED Must have one of the following certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Medical Coder (RMC), RHIA, RHIT or an associate's degree in medical office systems or health information management. · REQUIRED One (1) year of medical and/or dental billing and coding experience. Experience must be reflected in application; or submit copy of coder certification with application. · REQUIRED Demonstrated proficiency in technical knowledge of medical terminology, anatomy and physiology, and CPT and ICD-10-CM coding systems · REQUIRED to have Computer and/or word processor experience. · REQUIRED to submit to a background and character investigation, as per Tribal policy. Following hire must immediately report to Human Resource any citation, arrest, conviction for a misdemeanor or felony crime. · REQUIRED to submit to annual TB skin testing and adhere to KTHFS staff immunization policy in accordance with the Centers for Disease Control immunization recommendations for healthcare workers. · REQUIRED to accept the responsibility of a mandatory reporter in accordance with the Klamath Tribes Juvenile Ordinance Title 2, Chapter 15.64 and General Resolution #2005 003, all Tribal staff are considered mandatory reporters. Preferred Qualifications: AAPC coder certified, or AHIMA coder certified. · Experience with NextGen or other electronic health record systems is preferred. Indian Preference: · Indian Preference will apply as per policy. Must submit documentation with application to qualify for Indian Preference . ACKNOWLEDGEMENT This is intended to provide an overview of the requirements of the position. It is not necessarily inclusive, and the job may require other essential and/or non-essential functions, tasks, duties, or responsibilities not listed herein. Management reserves the sole right to add, modify, or exclude any essential or non-essential requirement at any time with or without notice. Nothing in this job description, or by the completion of any job requirement by the employee, is intended to create a contract of employment of any type. APPLICATION PROCEDURE Submit a Klamath Tribal Health & Family Services Application for Employment with all requirements and supporting documentation to: Klamath Tribal Health & Family Services ATTN: Human Resource 3949 South 6th Street Klamath Falls, OR 97603 *************************** IT IS THE RESPONSIBILITY OF THE APPLICANT TO PROVIDE SUFFICIENT INFORMATION TO PROVE QUALIFICATIONS FOR TRIBAL POSITIONS. Please Note: If requirements are not met, i.e., submission of a resume in lieu of a tribal application or not including a required certification, your application will not be reviewed and will be disqualified. Indian Preference will apply. In accordance with Klamath Tribal policy, priority in selection will be given to qualified applicants who present proof of eligibility for “Indian Preference”. Applications will not be returned.

BILLING SPECIALIST II HYBRID RESPONSIBLE TO: Business Office Manager SALARY: Step Range: 12 ($40,453 annually) - 31 ($70,934 annually); Full Benefits CLASSIFICATION: Non-Management, Regular, Full-Time LOCATION: Hybrid - Up to 80% Remote / 20% In Office after initial year of training period Klamath Tribal Health & Family Services 3949 S. 6th Street, Klamath Falls, Oregon BACKGROUND: Comprehensive POSITION OBJECTIVE Klamath Tribal Health & Family Services (KTHFS) is a tribally operated health facility offering direct medical, dental, pharmacy, behavioral health, and non-emergent transportation services to American Indians and Alaska Natives residing within the service delivery area. The Billing Specialist II is responsible for managing patient accounts in a complex, multi-disciplinary Business Office environment. The incumbent shall cross-train with other members of the Business Office and shall participate in all functions of the coding and billing cycle, to include: daily review of encounters, analyzing chart notes and assuring the appropriate service codes are utilized, data entry of encounter forms, posting charges into the computer system, perform claims review, claims submission, timely billing, follow-up and collection of all accounts, payment posting, claims audit and research. The incumbent shall also function as a resource for clinic providers and staff and will assist with coding and billing questions, and quality assurance activities. MAJOR DUTIES AND RESPONSIBILITIES 1. Daily review, analyze, and interpret patient ambulatory EHR and/or paper encounter coding and corresponding chart note documentation and determine that the appropriate diagnostic and procedural codes are used and appropriately reflected in the chart note for code assignment as outlined by the CMS guidelines. Assuring that medical necessity billing guidelines are met. 2. Ensure that the appropriate service codes are applied in the billing record that corresponds to the documentation referenced in the chart note or on the encounter forms. Ensure that the appropriate ICD-X, CPT, HCPCS, CDT coding conventions have been used for services provided by all health service types within KTHFS. 3. Work with providers, nursing staff, and the business office to clarify documentation in the EHR system if needed. Including correlating anatomical and physiological processes of a diagnosis to assure the most accurate and specified ICD-X code(s) are used. Advise manager and clinicians of deficiencies to support charge capture of all billable services. 4. Prepare and submit clean claims (electronic or paper) to primary/secondary insurance carriers including Medicaid, Medicare, (Part A&B), and private insurance companies. 5. Maintain compliance with billing regulations: including Medicaid , Medicare (Parts A&B, DME), and private Insurance Carriers. 6. Payment post insurance checks or EFTs, which includes: verifying the checks or EFTs that have been receipted in the Master Check's & EFT's Microsoft spreadsheet, batching the checks or EFTs into NextGen and then accurately posting the payments. 7. Process refunds for any overpayments made to KTHFS. Monitor claims payment and promptly request POs for refunds to insurance companies, or perform electronic claim adjustments per payer requirements, for any overpayments made on claims. The refund will also be processed to reflect the refunded claim in NextGen. 8. Process No-Pay EOBs by applying an adjustment and creating billing and claim follow-up notes. This includes the appeal of insurance claims that have been wrongfully paid or denied, contacting insurance companies by phone to obtain information concerning extent of benefits and/or settle unpaid claims and providing any additional information requested by insurance companies for the processing of submitted claims. 9. Record in NextGen system all claims related phone calls, correspondence, and activities related to each patient account. 10. Maintain current filing system for encounters, POs, etc., process daily incoming mail and correspondence for review, completion, and filing. 11. Communicate regularly with Patient Registration and record patient benefit effective/term date(s) into the practice management system as needed. 12. Create electronic batches to submit to the clearinghouse and reconcile with the submitted claims tracking spreadsheet including follow up on electronic claims receipt by payer. Correct any claims before archiving the file in the clearinghouse. 13. Work outstanding A/R by reviewing, rebilling, and adjusting accounts to ensure accurate and thorough billing of claims, by running reports and working on claims. Track and monitor claims processing, ensure timely follow-up for the payment of bills; Identify, and resolve all outstanding/pending claims. 14. Monitor the Business Office outlook inbox regularly and back bill any claims and/or adjust claims where applicable. 15. Run specific reports as identified below: · To be run and worked weekly - Pending Charges Report, Unbilled and Rebilled Encounters, Paper Claims printed, Clearinghouse Reports (claims denied, outstanding claims, claims removed, claims rejected) · Biweekly reports - Kept Appointments with No Encounters report, Aging Reports, and maintaining up to date reports making sure all old billing is addressed. 16. Establish and maintain an effective working relationship with public and private payers; identify potential problems that could cause interruptions to cash flow. 17. Participate in yearly chart audit activities for quality assurance purposes; document results in report format, as needed, for review by the Chief Medical Officer and the Chief Quality Officer. 18. Attend coding seminars, meetings, or other training opportunities to keep abreast of changes in the profession. 19. Like all employees of the Klamath Tribes, the incumbent will be called upon to accomplish other tasks that may not be directly related to this position, but are integral to the Klamath Tribes' broader functions, including but not limited to, assisting during Tribal sponsored cultural, traditional, or community events that enable the successful operation of programs and practices of The Klamath Tribes as aligned with The Klamath Tribes' Mission Statement. Some of these tasks may be scheduled outside of regular work hours, if necessary. SUPERVISORY CONTROLS Work under the supervision of the Business Office Manager, who provides general instructions. Work is assigned in terms of functional/organizational objectives. The manager assists with unusual situations that do not have clear precedents. Employees must be able to work with minimal supervision, using initiative and judgement in setting priorities to meet the demands of the workload. Work is performed within the purview of laws, and regulations. The manager will review work regularly for quality and compliance with established policies and procedures and payer guidelines. KNOWLEDGE, SKILLS, ABILITIES Technical knowledge, skill, and understanding of the American Medical Association developed CPT coding system to acquire, interpret, and resolve problems based on information derived from system monitoring reports to be carried over to the required billing forms. Technical knowledge, skill, and understanding of the concepts of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-X-CM) for classification of diseases and/or procedures. Knowledge and understanding of CDT dental coding system. Basic knowledge and understanding of HCPCS coding. Knowledge of mental health and alcohol and drug coding and billing is desirable. Ability to work with minimal supervision, using initiative and judgment in setting priorities to meet the demands of the workload while adhering to the insurance rules and regulations that relate to coding and billing. The knowledge of and/or the ability to learn the billing guidelines as they pertain to FQHC/Tribal Health Clinics. Knowledge of established procedures required claim forms (both paper and electronic) associated with the various health insurance programs. In-depth knowledge of Medicaid (OARs, Rulebooks). In-depth knowledge of Medicare Part A & B billing regulations. Knowledge of medical terminology. Knowledge of claims review, account auditing, and quality assurance. The ability of tracking, handling, and completing multiple projects. Ability to communicate well (both orally and in writing) and work effectively with other employees, managers, and administrators. This person should be able to express themselves in a clear and concise manner for the purposes of correspondence, reports and instructions, as well as for obtaining and conveying information to ensure a cooperative working relationship with all staff. Willingness to maintain expertise to keep current with changes in procedure and diagnosis coding and third-party payer reimbursement policies through continuing education. Above average ability to work with numbers and set standards to assure proper payment and adjustments posting. Must be dependable, thorough, accurate, well-organized and detail oriented. Ability to maintain strict confidentiality of medical records and adhere to the standards for health record-keeping, HIPAA and Privacy Act requirements. Conduct self in accordance with KTH&FS Employee Policy & Procedure Manual. QUALIFICATIONS, EXPERIENCE, EDUCATION Minimum Qualifications: Failure to comply with minimum position requirements may result in termination of employment. · REQUIRED Onsite training/working for the first year upon hire may be required. Up to 80% of remote work after training requirements are completed subject to business needs and management approval. · REQUIRED to possess a High School Diploma or Equivalent. ( Must submit a copy of diploma or transcripts with application.) · REQUIRED Must have one of the following certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Medical Coder (RMC), RHIA, RHIT or an associate's degree in medical office systems or health information management. · REQUIRED One (1) year of medical and/or dental billing and coding experience. Experience must be reflected in application; or submit copy of coder certification with application. · REQUIRED Demonstrated proficiency in technical knowledge of medical terminology, anatomy and physiology, and CPT and ICD-10-CM coding systems · REQUIRED to have Computer and/or word processor experience. · REQUIRED to submit to a background and character investigation, as per Tribal policy. Following hire must immediately report to Human Resource any citation, arrest, conviction for a misdemeanor or felony crime. · REQUIRED to submit to annual TB skin testing and adhere to KTHFS staff immunization policy in accordance with the Centers for Disease Control immunization recommendations for healthcare workers. · REQUIRED to accept the responsibility of a mandatory reporter in accordance with the Klamath Tribes Juvenile Ordinance Title 2, Chapter 15.64 and General Resolution #2005 003, all Tribal staff are considered mandatory reporters. Preferred Qualifications: · AAPC coder certified, or AHIMA coder certified. · Experience with NextGen or other electronic health record systems is preferred. Indian Preference: · Indian Preference will apply as per policy. Must submit documentation with application to qualify for Indian Preference . ACKNOWLEDGEMENT This is intended to provide an overview of the requirements of the position. It is not necessarily inclusive, and the job may require other essential and/or non-essential functions, tasks, duties, or responsibilities not listed herein. Management reserves the sole right to add, modify, or exclude any essential or non-essential requirement at any time with or without notice. Nothing in this job description, or by the completion of any job requirement by the employee, is intended to create a contract of employment of any type. APPLICATION PROCEDURE Submit a Klamath Tribal Health & Family Services Application for Employment with all requirements and supporting documentation to: Klamath Tribal Health & Family Services ATTN: Human Resource 3949 South 6th Street Klamath Falls, OR 97603 *************************** IT IS THE RESPONSIBILITY OF THE APPLICANT TO PROVIDE SUFFICIENT INFORMATION TO PROVE QUALIFICATIONS FOR TRIBAL POSITIONS. Please Note: If requirements are not met, i.e., submission of a resume in lieu of a tribal application or not including a required certification, your application will not be reviewed and will be disqualified. Indian Preference will apply. In accordance with Klamath Tribal policy, priority in selection will be given to qualified applicants who present proof of eligibility for “Indian Preference”. Applications will not be returned. Requirements:

. The Specialized Treatment for Optimized Programming (STOP) Program Area Six connects California Department of Corrections and Rehabilitation inmates and parolees to comprehensive, evidence-based programming and services during their transition into the community, with priority given to those participants who are within their first year of release and who have been assessed to as a moderate to high risk to reoffend. Area Six includes San Diego, Orange, and Imperial counties. STOP subcontracts with detoxification, licensed residential treatment programs, outpatient programs, professional services, and reeentry and recovery housing throughout the program area to assist participants with reentry and recovery resources. The Billing Coordinator is responsible for coordinating receipt of and reviewing Community Based Provider (CBP) subcontractor client data for accuracy and entering and retrieving data from/to the Automated Reentry Management System (ARMS) as needed for the purpose of reconciliation, invoicing and billing. Key Responsibilities Data Entry and Reconciliation Responsibilities: Review outgoing and incoming CBP subcontractor client data for accuracy. Enter data found on the verification form into the STOP database to begin the reconciliation process. When discrepancies are found, coordinate with CBPs and internal departments to resolve and reconcile the discrepancies. Ensure accuracy of all data entered. Billing and Invoicing Responsibilities: Process STOP CBP weekly verifications by extracting from the STOP database, and possibly further verifying in the ARMS database, and forwarding to the CBPs via email (and sometimes fax) for approval. Produce the monthly billing and forward to CBPs for billing authorization and approval. Ensures accuracy of all billing and resolves any discrepancies identified. Act as liaison between Fiscal department and STOP to ensure ease of information flow. Produce invoices for other various services (i.e. transportation, links etc.). Administrative Responsibilities: Produce monthly client and CBP related reports as needed for the California Department of Corrections and Rehabilitation (CDCR), with supervisor review and approval, using the ARMS database. Assure confidentiality of all incoming and outgoing client data. As assigned, performs other clerical tasks. And, other duties as assigned. Education and Knowledge, Skills and Abilities Education and Experience Required: High School Diploma or equivalent. Previous work experience working with spreadsheets. Previous work experience performing data entry. Type 45 wpm. Strong math skills. Desired: Bilingual. AA Degree; Experience may substitute for this on a year-by-year basis. We will consider for employment qualified applicants with arrest and conviction records. In compliance with the California Department of Public Health's mandate, all employees must be able to provide proof of COVID-19 vaccination. Medical and religious exemptions are available. Tag: IND100.

Job DescriptionBenefits: 401(k) matching Bonus based on performance Dental insurance Health insurance Paid time off Training & development Vision insurance JOB OVERVIEW: We are seeking a skilled and experienced Billing Coordinator to join our team at Your Home Assistant. As a Billing Coordinator, you will play a crucial role in completing complex activities associated with maintaining accurate and complete billing and accounts receivable records. Review appropriate reports to ensure billing data accuracy. Resolve billing discrepancies regularly. Ensure eligibility is verified regularly and accurately maintained and followed up accordingly to prevent lost revenue. RESPONSIBILITIES: Work within the scope of the position, in coordination with management, to meet the needs of our patients, families and professional colleagues. Accurately enter patient/customer billing data and charge accordingly Ensure that all potential payers have been identified, verified, and entered accurately into the computer system prior to submission of billing and within deadlines per company policies and procedures. Ensure that insurance-related documentation is secured, completed, reviewed, accurate, and submitted per company and state requirements. This includes election, certifications, and authorization-related documentation required for billing. Maintain tracking tools and diaries to ensure that all necessary information is secured for timely accurate payment. Alert appropriate management team members regarding late or missing documents required for billing. Perform and ensure regular review and resolve discrepancies of accounts receivables according to Company procedures, policy, internal controls, and payer requirements. Establish and maintain positive working relationships with patient/clients, payors, and other customers. Maintain the confidentiality of patient/client and agency information at all times. Assure for compliance with local, state and federal laws, Medicare regulations, and established company policies and procedures, including published manuals and responsibility matrixes Meet or exceed delivery of Company Service Standards in a consistent fashion. Interact with all staff in a positive and motivational fashion supporting the Companys mission. Conduct all business activities in a professional and ethical manner. The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents will be requested to perform job-related tasks other than those stated in this description. QUALIFICATIONS Minimum age requirement of 18. High School graduate or GED required. Two years experience in healthcare data entry, preferably in homecare Cal-Aim, Tri-west, Long Term Care Insurance experience preferred Two-year degree in accounting or equivalent insurance/bookkeeping preferred Strong computer skills, including Word, Excel, and PowerPoint. Strong analytical skills, organized work habits and proven attention to detail. Excellent communication skills, ability to work independently and in a team environment. Good customer relation skills. Ability, flexibility and willingness to learn and grow as the company expands and changes. Demonstrated leadership ability to initiate duties as required. Plan, organize, evaluate, and manage PC files and Microsoft Office. Compliance with accepted professional standards and practices. Ability to work within an interdisciplinary setting. Satisfactory references from employers and/or professional peers. Satisfactory criminal background check. Self-directed with the ability to work with little supervision. Flexible and cooperative in fulfilling all obligations. Job Type: Full-time Benefits: 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Schedule: 8 hour shift Day shift Monday to Friday Ability to Relocate: Elk Grove, CA 95758: Relocate before starting work (Required) Work Location: In person

Navajo Preference Employment Act In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference. Overview POSITION SUMMARY The purpose of the position is to manage and lead the medical, pharmacy and dental billing of third-party payers applicable to outpatient, inpatient, ancillary, ambulatory surgery and professional services. Incumbent is responsible for management, providing technical direction and submission of properly executed claims in a timely manner to third party payers, responsible parties, and resubmission of corrected claims. Maximize reimbursement and minimize denied payments. Understand and monitor Patient Financial Key Performance Indicators while achieving the Clean Claim Goal established for TCRHCC. Responsibilities will also include delegation and assistance to the Director of Revenue Cycle. Qualifications NECESSARY QUALIFICATIONS Education: Associate degree in Business Administration or related business field (Finance, Accounting, Administration, etc.) Experience: * Minimum three-years of successful supervisory or management * Minimum five-year experience as a medical billing technician in a tribal or non-profit healthcare patient accounting * Demonstrated knowledge of ICD-10, and CPT/HCPCS coding/billing procedures, Uniform Hospital Discharge Data definitions regarding diagnostic and procedural sequencing in order to interpret and resolve problems based on information derived from system monitoring reports and the UB-04, HCFA-1500, and ADA billing forms submitted to the third-party * Computer skills: ability to access and use multiple data License/Certification: * Obtain a Certification as a Revenue Cycle Representative through the Healthcare Financial Management Association (HFMA) one year from date of hire. Failure to obtain certification will result in termination of employment at TCRHCC. Other Skills and Abilities: A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas: * Positive working relationships with others * Possession of high ethical standards and no history of complaints * Reliable and dependable; reports to work as scheduled without excessive absences and no reported attendance issues * Ability to plan and lead effective team meetings and training * Possess expertise in professional communication, interpersonal, organizational leadership and team building skills * Possess excellent customer services skills for internal and external customers * Ability to work under pressure and making quality and effective decisions * Ability to positively motivate individuals and teams to meet or exceed department expectations/goals. * Completion of and above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job * Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job * Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job * Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading or incomplete information, as determined by MENTAL AND PHYSICAL EFFORT The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: The work is primarily sedentary, must have ability to sit for a prolonged period of time, and occasionally stand, walk, drive, bend, climb, kneel, crouch, twist, maintain balance, and reach. Must have ability to lift, push and pull over 100lbs occasionally. Sensory Requirements for position include prolonged telephone use, frequent far, near and color vision, depth perception, seeing fine details, hearing normal speech, and hearing overhead pages. Must have ability of both hand manipulation in prolonged use of keyboards, and frequent simple/firm grasping and fine manipulation. Mental: Exercises initiative and judgment in deviating from existing department or corporation practices to resolve billing issues/concerns. Work is reviewed for conformance to policies, procedures, and practices relating to billing practices. Must have ability of prolonged concentration and to work alone, frequent ability to cope with high levels of stress, make decisions under high pressure, handle multiple priorities in stressful situation, demonstrate high degree of patience, adapt to shift work, work in areas that are close and crowded, and occasionally cope with anger/fear/hostility of others in a calm way, manage altercations, and handle a high degree of flexibility including frequently accepting a flexible schedule to meet unit needs. Environmental: May occasionally be exposed to infectious disease, chemical agents, dust, fumes, gases, extremes in temperature or humidity, hazardous or moving equipment, unprotected heights, and loud noises. Responsibilities ESSENTIAL FUNCTIONS: * Manages and leads the billing functions and staff in the medical (Institutional & Professional), Pharmacy and Dental, billing and * Thorough knowledge of third-party payer rules and regulations (i.e. Medicare, Medicaid, Managed Care, Commercial Insurance, Workers' Compensation, Motor Vehicle Insurance) * Experienced with charge master, EDI claims, medical billing, E.H.R., CCI Edits and Claims Scrubbing, and Insurance Verification of Benefits systems. * Develops, implements and maintains billing policies and * Establishes and maintains a working relationship with Medicare and Medicaid intermediaries, state and federal agencies, area employers and private insurance * Proficient with MS Excel and Word software * Develops statistical reports and control methods, which identify insurer billing requirements, and productivity standards and results. Identifies limitations and provides information for staff * Provides technical assistance to management, medical providers, patients and other facility personnel by obtaining information relative to medical billing requirements, covered services, audit reports, or billing statistics, * Coordinates and oversees work of staff; has the responsibility of distributing workloads as * Responsible for maintaining time and attendance in timekeeping system of * Monitors productivity of staff to ensure it meets production Assures staff is provided a work environment conducive to productivity and good health. * Trains employees and holds periodic (in-house) training sessions. Assists in interpreting regulations, requirements and procedures; provides technical assistance to resolve patient accounting system * Reviews staff work for conformance to policies, procedures, and practices relating to Alternate Resources regulations, review of appropriate E&M, correct CPT/HCPCS codes, American Medical Association (AMA) requirements, American Dental Association (CDT-2), and the Health Care Finance Administration (HCFA) * Prepares and conducts employee job performance evaluations and forwards to Director of Revenue Cycle for * Responsible for the orientation and education of staff to ensure compliance with new and existing regulations of third party payers (i.e. covered services, limitations, ). * Assists with testing of new software, implementation of new payer requirements and guidelines, CMS regulatory guidelines, new process flows, * Evaluates and addresses issues and concerns relative to daily operations of assigned areas, also provides recommendation/suggestion to improve the overall operations (i.e. cost containment via personnel management) to the Director of Revenue Cycle * Responsible to initiate, carry out, and enforce disciplinary action policy and procedure with staff when * Verifies accuracy of services and billed amounts, and that services are allowed by appropriate regulations, directives and payer guidelines. * Identifies errors, omissions, duplications in documents and contacts the appropriate individuals to resolve * Responsible for providing monthly reports, organizing schedules (i.e. regular, overtime, ). * Attends and participates in management meetings as * Accepts delegation in the absence of immediate * Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH- approved N95 filtering facepiece respirator or higher, if available), and eye or face * Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE (see CDC website for most current updates) * Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer * Performs other duties and special projects as assigned or required.

Key Responsibilities: * Order Confirmation & Claim Preparation: Process and confirm orders, ensuring claims are accurately prepared and submitted. * Cash Posting: Post payments and update accounts in a timely and accurate manner. * Patient Support: Address any patient inquiries regarding billing, ensuring clear communication and prompt issue resolution. * Accounts Receivable Management: Work on stop/held accounts to ensure timely billing for rental items. * Meet Department Goals: Achieve performance metrics and goals set by the department to maintain operational efficiency. * Collaboration with Teams: Regularly communicate with Billing and Insurance team leads to report progress and trends Pay: $17.00 hour Benefits: * BCBS Medical * BCBS Vision * Dental Insurance * 401K * PTO Benefits

BILLING SPECIALIST II RESPONSIBLE TO: Business Office Manager SALARY: Step Range: 12 ($40,453) -31($70,934); Full Benefits CLASSIFICATION: Non-Management, Regular, Full-Time LOCATION: Klamath Tribal Health & Family Services 3949 S. 6th Street, Klamath Falls, Oregon BACKGROUND: Comprehensive POSITION OBJECTIVE Klamath Tribal Health & Family Services (KTHFS) is a tribally-operated health facility offering direct medical, dental, pharmacy, behavioral health, and non-emergent transportation services to Native Americans and Alaska Natives residing within the service delivery area. The Billing Specialist is responsible for managing patient accounts in a complex, multi-disciplinary Business Office environment. The incumbent shall cross-train with other members of the Klamath Tribal Health Business Office Staff and shall participate in all functions of the coding and billing cycle, to include: daily review of encounters, analyzing chart notes and assuring the appropriate service codes are utilized, data entry of encounter forms, posting charges into the computer system, perform claims review, claims submission, timely billing, follow-up and collection of all accounts, payment posting, claims audit and research. The incumbent shall also function as a resource for clinic providers and staff and will assist with coding and billing questions, and quality assurance activities. MAJOR DUTIES AND RESPONSIBILITIES 1. Daily review, analyze, and interpret patient ambulatory EHR and/or paper encounter coding and corresponding chart note documentation and determine that the appropriate diagnostic and procedural codes are used and appropriately reflected in the chart note for code assignment as outlined by the CMS guidelines. Assuring that medical/dental necessity billing guidelines are met. 2. Ensure the appropriate service codes are applied in the billing record that corresponds to the documentation referenced in the chart note or on the encounter forms. Ensure that the appropriate ICD-10, CPT, HCPCS, CDT coding conventions have been used for services provided by all health service types within KTHFS, including but not limited to: medical, dental, behavioral health and transportation. 3. Work with providers and nursing staff to clarify documentation in the EHR system if needed. Including correlating anatomical and physiological processes of a diagnosis to assure the most accurate ICD-10 code(s) are used. Advise supervisor and clinicians of deficiencies to support charge capture of all billable services. 4. Prepare and submit clean claims (electronic or paper) to primary/secondary insurance carriers including Medicaid, Medicare, (Part A&B), and private insurance companies. 5. Maintain compliance with billing regulations: including Medicaid (DMAP), Medicare (Parts A&B, DME), Private Insurance Carriers (i.e. HMA, BCBS, ODS, etc.). 6. Payment post insurance checks or EFTs, which includes: verifying the checks or EFTs that have been receipted in the KTHFS Operations Support System, batching the checks or EFTs into the current billing system, and then accurately posting the payments into the current billing system. 7. Process refunds for any overpayments made to KTHFS. Monitor claims payment and promptly request POs for refunds to insurance companies, or perform electronic claim adjustments per payer requirements, for any overpayments made on claims. The refund will also be processed to reflect the claim refund in the practice management system. 8. Process No-Pay EOBs, applying an adjustment, create billing notes and claim follow-up. This includes the appeal of insurance claims that have been wrongfully paid or denied, contacting insurance companies by phone to obtain information concerning extent of benefits and/or settle unpaid claims and providing any additional information requested by insurance companies for the processing of submitted claims. 9. Record in NextGen system all claims related phone calls, correspondence, and activities related to each patient account. 10. Maintain current filing system for encounters, POs, & etc.; process daily incoming mail and correspondence for review, completion, and filing. 11. Communicate regularly with Patient Registration Staff and record patient benefit effective/term date(s) into the practice management system as needed. 12. Create electronic batches to submit to clearinghouse in Nextgen and reconcile to claims spreadsheet including follow up on electronic claims receipt by payer. Correct any claims before archiving the file in the clearinghouse. 13. Work outstanding A/R by reviewing, rebilling, and adjusting accounts to ensure accurate and thorough billing of claims, by running reports and working on claims. Track and monitor claims processing, ensure timely follow-up for the payment of bills; Identify, and resolve all outstanding/pending claims. 14. Monitor the Business Office outlook inbox regularly and back bill any claims and/or adjust claims where applicable. 15. Run specific reports as identified below: · To be ran and worked weekly - Pending Charges Report, Unbilled Encounters, Paper Claims printed, Clearinghouse Reports (claims denied, outstanding claims, claims removed, claims rejected) · Biweekly reports - Kept Appointments with No Encounters report, Aging Reports, and maintain up to date reports making sure all old billing is addressed. 16. Establish and maintain an effective working relationship with public and private payers; identify potential problems that could cause interruptions to cash flows. 17. Participate in yearly chart audit activities for quality assurance purposes; document results in report format, as needed, to be able to have reviewed by Clinical Director and Compliance Officer. 18. Attend coding seminars, meetings, or other training opportunities to keep abreast of changes in the profession. 19. Like all employees of the Klamath Tribes, the incumbent will be called upon to accomplish other tasks that may not be directly related to this position, but are integral to the Klamath Tribes' broader functions, including but not limited to, assisting during Tribal sponsored cultural, traditional, or community events that enable the successful operation of programs and practices of The Klamath Tribes as aligned with The Klamath Tribes' Mission Statement. Some of these tasks may be scheduled outside of regular work hours, if necessary. SUPERVISORY CONTROLS Work under the supervision of the Business Office Manager, who provides general instructions. Work is assigned in terms of functional/organizational objectives. The manager assists with unusual situations that do not have clear precedents. Employee must be able to work with minimal supervision, using initiative and judgement in setting priorities to meet the demands of the workload. Work is performed within the purview of laws, and regulations. The manager will review work regularly for quality and compliance with established policies and procedures and payer guidelines. KNOWLEDGE, SKILLS, ABILITIES Technical knowledge, skill, and understanding of the American Medical Association developed CPT coding system in order to acquire, interpret, and resolve problems based on information derived from system monitoring reports to be carried over to the required billing forms. Technical knowledge, skill, and understanding of the concepts of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for classification of diseases and/or procedures. Knowledge and understanding of CDT dental coding system. Basic knowledge and understanding of HCPCS coding. Knowledge of mental health and alcohol and drug coding and billing is desirable. Ability to work with minimal supervision, using initiative and judgment in setting priorities to meet the demands of the workload while adhering to the insurance rules and regulations that relate to coding and billing. The knowledge of and/or the ability to learn the billing guidelines as they pertain to FQHC/Tribal Health Clinics. Knowledge of established procedures, required claim forms (both paper and electronic) associated with the various health insurance programs. In-depth knowledge of Medicaid (OARs, Rulebooks). In-depth knowledge of Medicare Part A & B billing regulations. Knowledge of medical terminology. Knowledge of claims review, account auditing, and quality assurance. The ability of tracking, handling, and completing multiple projects. Ability to communicate well (both orally and in writing) and work effectively with other employees, managers, and administrators. This person should be able to express themselves in a clear and concise manner for the purposes of correspondence, reports and instructions, as well as for obtaining and conveying information to ensure a cooperative working relationship with all staff. Willingness to maintain expertise to keep current with changes in procedure and diagnosis coding and third-party payer reimbursement policies through continuing education. Above average ability to work with numbers and set standards in order to assure proper payment and adjustment posting. Must be dependable, thorough, accurate, well-organized and detail oriented. Ability to maintain strict confidentiality of medical records and adhere to the standards for health record-keeping, HIPAA and Privacy Act requirements. Conduct self in accordance with KTH&FS Employee Policy & Procedure Manual. QUALIFICATIONS, EXPERIENCE, EDUCATION Minimum Qualifications: Failure to comply with minimum position requirements may result in termination of employment. · REQUIRED to possess a High School Diploma or Equivalent. ( Must submit copy of diploma or transcripts with application.) · REQUIRED Must have one of the following certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Medical Coder (RMC), RHIA, RHIT or an Associate's degree in Medical Office Systems or Health Information Management. · REQUIRED One (1) year of medical and/or dental billing and coding experience. Experience must be reflected on application; or submit copy of coder certification with application · REQUIRED Demonstrated proficiency in the technical knowledge of medical terminology, anatomy and physiology, and CPT and ICD-10-CM coding systems · REQUIRED to have Computer and/or word processor experience. · REQUIRED to submit to a background and character investigation, as per Tribal policy. Following hire must immediately report to Human Resource any citation, arrest, conviction for a misdemeanor or felony crime. · REQUIRED to submit to annual TB skin testing and adhere to KTHFS staff immunization policy in accordance with the Centers for Disease Control immunization recommendations for healthcare workers. · REQUIRED to accept the responsibility of a mandatory reporter in accordance with the Klamath Tribes Juvenile Ordinance Title 2, Chapter 15.64 and General Resolution #2005 003, all Tribal staff are considered mandatory reporters. Preferred Qualifications: AAPC coder certified or AHIMA coder certified. · Experience with NextGen or other electronic health record system is preferred. Indian Preference: · Indian Preference will apply as per policy. Must submit documentation with application to qualify for Indian Preference . ACKNOWLEDGEMENT This is intended to provide an overview of the requirements of the position. It is not necessarily inclusive, and the job may require other essential and/or non-essential functions, tasks, duties, or responsibilities not listed herein. Management reserves the sole right to add, modify, or exclude any essential or non-essential requirement at any time with or without notice. Nothing in this job description, or by the completion of any requirement of the job by the employee, is intended to create a contract of employment of any type. APPLICATION PROCEDURE Submit a Klamath Tribal Health & Family Services Application for Employment with all requirements and supporting documentation to: Klamath Tribal Health & Family Services ATTN: Human Resource 3949 South 6th Street Klamath Falls, OR 97603 *************************** IT IS THE RESPONSIBILITY OF THE APPLICANT TO PROVIDE SUFFICIENT INFORMATION TO PROVE QUALIFICATIONS FOR TRIBAL POSITIONS. Please Note: If requirements are not met, i.e., submission of a resume in lieu of a tribal application or not including a required certification, your application will not be reviewed and will be disqualified. Indian Preference will apply. In accordance with Klamath Tribal policy, priority in selection will be given to qualified applicants who present proof of eligibility for “Indian Preference”. Applications will not be returned.

Develop and grow service line referrals to achieve volume and revenue objectives for the LA Medical Foundation and Medical Groups. Referral activities target physicians in primary and secondary service areas, including new physician markets in the Southern California - LA region. Direct outreach activities toward new physicians and existing physicians who provide services to various ministries across Los Angeles. In conjunction with director, implement long-and short-term strategies to promote emergent and elective referrals and service-line objectives; retain existing business, and develop new business. Sustain referral opportunities through ongoing education, communication, and service recovery. Create opportunities for physician-to-physician dialog. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Medical Institute and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required qualifications: + 1 year of Sales experience. Preferred qualifications: + Bachelor's Degree in Marketing, Science, or Nursing or equivalent education/experience + 3 years of Sales experience. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act." About the Team Providence Clinical Network (PCN) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers. PCN is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington's greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence's St. John's Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 401899 Company: Providence Jobs Job Category: Business Development Job Function: Marketing/Public Relations/Community Affairs Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 7010 BUSINESS DEVELOPMENT CA TORRANCE Address: CA Torrance 3460 Torrance Blvd Work Location: PMI Torrance Workplace Type: On-site Pay Range: $39.45 - $61.24 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

What we are looking for NextCare Urgent Care is looking for a Billing Coordinator to be a part of our Urgent Care Team. Responsibilities The Billing Coordinator will be responsible for the daily billing of claims for all carriers. This position will monitor and distribute the APN reports from the clearinghouse and insurance carriers and communicate this information back to the Billing Supervisor. This position will also assist in the posting of contractual, courtesy adjustments, as well as monitoring contractual analysis reports. This position will be assist with the table maintenance of the electronic billing system and clearinghouse information flow. They will be responsible for communicating billing trends to the manager as well as patient statement processing. How you will make an impact The Billing Coordinator supports the organization with the following: * Responsible for the daily billing of claims to insurance carriers based on contract requirements. * Help train new employees with NextGen, contracts, and business office Policies and Procedures. * Monitor and distribute the APN reports generated by the clearinghouse and insurance carriers. * Help post contractual adjustments and transfer deductibles to patient accounts. * Assist with claim resubmission projects when necessary. * Assist in maintaining Navicure with Waystar. * Assist with reviewing accounts that have partial or under payments. * Clean out daily the clearinghouse rejections and claims with errors held in the system. * Post adjustments to accounts based on contractual rates and deductibles. * Review accounts to determine if billed correctly. * Assist other members of the team as needed. Essential Education, Experience and Skills: Minimum Education: High School diploma or equivalent. Experience: * Must have two years' experience billing, collections, payment posting, and electronic and paper claims. * Experience with Managed Care contracts, Medicare and AHCCCS. * Basic insurance knowledge, reading patient eligibility and benefit coverage details. * Experience with revenue cycle and reimbursement in a healthcare facility. * Microsoft Programs, Windows, Excel, Word, and Teams. * Internet browser knowledge (basics) for Edge or Chrome. Valued But Not Required Education, Experience and Skills: Experience: Medical collections experience; NextGen software experience: Previous supervision experience in the healthcare field is helpful, Waystar Clearinghouse, Payer Provider Portals, and Basic Terminology of Medical Billing Practices.

Job Details Position Type: Full Time Education Level: High School Diploma/GED Salary Range: Undisclosed Travel Percentage: In-Office Job Shift: Day Shift Job Category: Accounting/Finance Description Terros Health is pleased to share an exciting and rewarding opportunity for a full-time Billing Specialist I working at our Central Ave location in Phoenix, AZ. Reporting to the Director of Claims and Credentialing. Billing Specialist I will assist with the successful claims processing and billing functions for the organization, including billing of all service types and to all third-party payers. Terros Health is a healthcare organization of caring people, guided by our core values of integrity, compassion and empowerment, with diversity woven throughout. We engage people in whole person health through an integrated care delivery system, thus establishing a medical home for our patients. In caring for the whole person, we focus on overall wellness through physical health, mental health and substance use care. Our mission is to provide extraordinary care by empowered people through exceptional outcomes. HOPE ~ HEALTH ~ HEALING Terros Health made the list!! "Most Admired Companies of 2020, 2022 & 2023" as awarded by AZ Big Media. Duties Include: * Preparing and reviewing claims for submission, including resolving upfront claims edits and errors. * Submission and tracking of claims files (837s) to all payer types. * Resolving payer and clearing house related issues such as rejections (999s and 277s). * Tracking work through system tasks and queues. * Meeting or exceeding productivity guidelines. * Identify and report any claims billing issues to management. * May assist with special projects such as rebilling, coding, and configuration. Apply with your resume at ******************** Benefits & Wellness * Multiple medical plans - including a no premium plan for employees and their families * Multiple dental plans - including orthodontia * Financial well-being - 401(k) with a company match, interest free medical line of credit, financial education, planning, and support * 4 Weeks of paid time off in the first year * Wellness program * Pet Insurance * Group life and disability insurance * Employee Assistance Program for the Whole Family * Personal and family mental and physical health access * Professional growth & development - including scholarships, clinical supervision, and CEUs * Tuition discounts with GCU and The University of Phoenix * Working Advantage - Employee perks and discounts * Gym memberships * Car rentals * Flights, hotels, movies and more * Bilingual pay differential Qualifications * High School diploma or equivalent * 1+ years medical and/or behavioral billing experience * 1+ years experience with medical terminology and using an electronic medical record and billing system * Demonstrated knowledge of Healthcare Common Procedure Coding System (HCPC), Current Procedural Terminology (CPT), and diagnosis coding * Intermediate knowledge of Microsoft suite, especially excel functions and tools * This role is a non-driving position. This position is performed at one location and does not require travel to various Terros Health centers. May be 18 years of age and with less than two years' driving experience or no driving experience. * Must pass background check, TB test and other pre-employment screening. Physical demands of this position 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.

Job Details Central - Phoenix, AZ Full Time High School Diploma/GED In-Office Day Shift Accounting/FinanceDescription Terros Health is pleased to share an exciting and rewarding opportunity for a Full Time Billing Specialist II based out of our administrative office in Phoenix, AZ. Reporting to the Transactional Claims Lead, the ideal individual is flexible, compassionate and professional. Terros Health is a healthcare organization of caring people, guided by our core values of integrity, compassion and empowerment. We engage people in whole person health through an integrated care delivery system, thus establishing a medical home for our patients. In caring for the whole person, we focus on overall wellness through physical health, mental health and substance use care. Our mission is to provide extraordinary care by empowered people through exceptional outcomes. HOPE ~ HEALTH ~ HEALING Terros Health made the list!! "Most Admired Companies of 2020, 2022 & 2023" as awarded by AZ Big Media. Billing Specialist II will assist with the successful claims processing and billing functions for the organization, including billing of all service types and to all third-party payers. As a level II, this position will help train and mentor teammates, and may work special projects as assigned my management. This position reports to the Transactional Claims Lead. Preparing and reviewing claims for submission, including resolving upfront claims edits and errors. Submission and tracking of claims files (837s) to all payer types. Resolving payer and clearing house related issues such as rejections (999s and 277s). Tracking work through system tasks and queues. Identify and report any claims billing issues to management. Assists manager with special projects. Train and mentor teammates; perform audit and review of work performed during training period. Ensure timely, high quality work completion by completing work audits as needed. Apply with your resume at ******************** Benefits & Wellness: Multiple medical plans - including a no premium plan for employees and their families Multiple dental plans - including orthodontia Financial well-being - 401(k) with a company match, interest free medical line of credit, financial education, planning, and support 4 Weeks of paid time off in the first year Wellness program Child Care Support Program Pet Insurance Group life and disability insurance Employee Assistance Program for the Whole Family Personal and family mental and physical health access Professional growth & development - including scholarships, clinical supervision, and CEUs Employee perks and discounts Gym memberships Tuition at GCU and University of Phoenix Car rentals Qualifications High School diploma or equivalent 4+ years medical and/or behavioral billing experience 4+ years experience with medical terminology and using an electronic medical record and billing system Demonstrated knowledge of Healthcare Common Procedure Coding System (HCPC), Current Procedural Terminology (CPT), and diagnosis coding Intermediate knowledge of Microsoft suite, especially excel functions and tools This role is a non-driving position. This position is performed at one location and does not require travel to various Terros Health centers. May be 18 years of age and with less than two years' driving experience or no driving experience. Must pass background check, TB test and other pre-employment screening Physical demands of this position 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.

Job Details Earll - Phoenix, AZ Full Time High School Diploma/GED In-Office Day Shift Accounting/FinanceDescription Terros Health is pleased to share an exciting and rewarding opportunity for a full-time Billing Specialist I working at our Earll location in Phoenix, AZ. Reporting to the Director of Claims and Credentialing. Billing Specialist I will assist with the successful claims processing and billing functions for the organization, including billing of all service types and to all third-party payers. Terros Health is a healthcare organization of caring people, guided by our core values of integrity, compassion and empowerment, with diversity woven throughout. We engage people in whole person health through an integrated care delivery system, thus establishing a medical home for our patients. In caring for the whole person, we focus on overall wellness through physical health, mental health and substance use care. Our mission is to provide extraordinary care by empowered people through exceptional outcomes. Recently awarded among Arizona's Most Admired Companies in 2023 by AZ Big Media Duties Include: Preparing and reviewing claims for submission, including resolving upfront claims edits and errors. Submission and tracking of claims files (837s) to all payer types. Resolving payer and clearing house related issues such as rejections (999s and 277s). Tracking work through system tasks and queues. Meeting or exceeding productivity guidelines. Identify and report any claims billing issues to management. May assist with special projects such as rebilling, coding, and configuration. Apply with your resume at ******************** Benefits & Wellness • Multiple medical plans - including a no premium plan for employees and their families • Multiple dental plans - including orthodontia • Financial well-being - 401(k) with a company match, interest free medical line of credit, financial education, planning, and support • 4 Weeks of paid time off in the first year • Wellness program • Child Care Support Program • Pet Insurance • Group life and disability insurance • Employee Assistance Program for the Whole Family • Personal and family mental and physical health access • Professional growth & development - including scholarships, clinical supervision, and CEUs • Employee perks and discounts • Gym memberships • Tuition at GCU and University of Phoenix • Car rentals Qualifications High School diploma or equivalent 1+ years medical and/or behavioral billing experience 1+ years experience with medical terminology and using an electronic medical record and billing system Demonstrated knowledge of Healthcare Common Procedure Coding System (HCPC), Current Procedural Terminology (CPT), and diagnosis coding Intermediate knowledge of Microsoft suite, especially excel functions and tools This role is a non-driving position. This position is performed at one location and does not require travel to various Terros Health centers. May be 18 years of age and with less than two years' driving experience or no driving experience. Must pass background check, TB test and other pre-employment screening. Physical demands of this position 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.

Job Description FUNCTION/OVERVIEW: This position will focus on accuracy in reviewing and assessing insurance denials or returned claims. Must be able to communicate with insurance companies and clients from a resolution based perspective. This communication should be focused on acquired knowledge, insurance carrier guidelines, company policies & procedures, research and collection efforts. In addition to following up on claims, the collection specialist will be responsible for sending out medical records and writing appeals for denials to the insurance companies. PRIMARY DUTIES/RESPONSIBILITIES: Promote the mission, values and vision of the organization. Provide excellent customer service for clients; practices confidentiality and privacy protocols in accordance with HIPAA requirements. Accurately and thoroughly enters data / notes into the electronic system for follow up. Assists with follow up on claims processed to ensure payment to the agency. Works directly with payers to verify client eligibility and client payment responsibility including co-pays, deductibles, co-insurance, and/or out of pocket maximums. Assists as needed with follow-up on insurance denials, appeals, and reconsiderations. Assists as needed with all billing tasks and functions related to insurance, grant, and client billing. Responsible for investigating insurance rejected claims and the re-processing of denied claims and/or appeals of denied or underpaid claims. Identify denial patterns, as well as notifying senior management of payment delay issues. Contacts insurance companies regarding outstanding accounts. QUALIFICATIONS REQUIRED: High School Diploma or GED equivalent with combination of education and work experience, required; Bachelor's degree, preferred. Minimum of two (2) years' experience in Substance abuse Billing, Coding and Collections. Knowledge of Third Party payers, billing requirements and reimbursement methods; knowledge of medical terminology. Knowledge of claims reimbursement and collection efforts for the field of Substance Abuse treatment. Relevant computer software and hardware applications proficiency - Word, Excel, PowerPoint, Outlook, Electronic Medical Records, Billing Systems and/or other scheduling applications; KIPU preferred, Collaborate MD SKILLS: Strong communication skills, both written and verbal. Ability to work independently, as well as part of a team. Manage multiple tasks and set priorities. Ability to handle highly sensitive and confidential information. Ability to work in a fast-paced, high-energy environment. Excellent interpersonal and customer-facing skills. Ability to work accurately, with attention to detail.

Job Details 1100_TPA_2818 W Virginia Ave - Tampa, FL Full Time Non-Clinical StaffDescription Women's Care, founded in 1998, is a leading women's healthcare group in the United States, dedicated to providing the highest quality of care for women through their reproductive years and beyond. With 100+ locations and over 400 OB/GYNs and specialists across the country, Women's Care provides comprehensive patient care in obstetrics, gynecology, gynecologic oncology, urogynecology, gynecologic pathology, breast surgery, genetic counseling, maternal fetal medicine, laboratory services, and fertility. The Patient Access Representative is the first face and voice of Women's Care and is a critical role for the practice. They are the first touchpoint that begins the patient experience, with customer service being at the forefront. The Patient Access Representative collects information for registration of new and/or incoming patients, confirms that we have up-to-date information to ensure a complete and accurate scheduling and billing encounter, and ensures our patient's experience with us is extraordinary. Greet all patients and visitors with a smile in a prompt and courteous manner. Obtain and confirm patient demographics and update patient profile, including proper patient identification according to the Women's Care patient identification policy. Collect payment and/or assist patient with billing concern while ensuring practices meet time of service collection expectations and goals. Scan insurance card, ID, and other pertinent information into EMR system (HIPAA compliance, authorizations, medical records, etc.). Set up payment plans for patients unable to pay balances per Women's Care Payment Plan policy. Must have a full understanding of the financial policies and patient forms to be able to clearly answer any questions. Answer a high volume of incoming phone calls and respond to patient emails promptly while in accordance with the Women's Care Values Confirm all unconfirmed appointments for the next business day. Monitor the lobby frequently to ensure no one has been waiting too long and keep patients informed if provider delays occur. May assist patients who are having difficulty with online registration or completion of forms. Schedule or reschedule appointments. May act as a back up to verify patient insurance information and determine possible patient payment responsibility. Verify that all patients have had insurance eligibility and registration completed prior to being seen by the provider. Schedule any follow up appointments upon patient check out. Ensure all appointments in eCW are “checked out” at the end of each day or appropriately updated. Ensure that the lobby and front area are always kept tidy and presentable. And, if necessary, cleaning the waiting room. Demonstrate and embody the Women's Care mission and core values. Compliance with all HIPAA rules, regulations, and guidelines. Other duties as assigned. Qualifications Qualifications: High school diploma or equivalent required. Must have exceptional customer service experience and a true desire to help others while providing a positive patient experience at every encounter. Strong organizational skills required. Must have a customer-centric focus and present themselves in warm, welcoming, and professional demeanor. Strong verbal and written communication skills. Deadline-driven and detail-oriented. High level of computer literacy with the ability to use and/or quickly learn computer programs including Microsoft Office. Ability to multi-task in a high-volume and dynamic atmosphere. Ability to communicate and work efficiently with patients, co-workers, and providers. Must be dependable, reliable, and punctual. Preferred Skills: Preferably one year of experience working in a medical office or healthcare setting, OBGYN a plus. General knowledge of medical terminology and billing is beneficial. Preferred experience working with an electronic medical records system, specifically eClinicalWorks (eCW) a plus. WHY JOIN WOMEN'S CARE? We Offer: Competitive compensation package Health, dental, and vision benefits Paid time off and paid holidays 401k plan An opportunity to make a difference in patients' lives every day! Women's Care has grown tremendously through the years and expects to accelerate its growth with plans to expand rapidly into new markets across the U.S. With the commitment of our employees, we remain true to our mission of ‘Improving the Health of Women Every Day.' At Women's Care, we CARE about our patients, and we stand by our values. Compassion & Empathy: Treating patients like valued friends and family Accountability: Taking responsibility for our actions and behaviors Respect: Acting respectfully in every interaction Excellence & Quality: Providing the safest, highest quality of care