Billing & Collections Specialist

At ACHC, we are committed to improving the health and well-being of our communities. As a Federally Qualified Health Center and licensed primary care clinic, we provide comprehensive medical and dental services, along with specialized care in Chiropractic, Internal Medicine, Neurology, Pediatrics, Psychology, Podiatry, and Optometry. With clinics located across Fresno, Kings, and Tulare counties, our team works together to deliver accessible, high-quality care to every patient.

SUMMARY

The Billing & Collections Specialist performs billing, follow-up and collection procedures, including review and clarification of patient accounts against program provisions (e.g., Medicare, Medi-Cal, Blue Cross, etc.). Resolves routine patient billing inquiries and problems. Oversees the Admission and Discharge clerical functions, and covers those areas as needed. Must have strong working knowledge of computer systems.

EXAMPLES OF TASKS

• Following prescribed procedures, bills insurance carriers for appropriate payments after performing the necessary verification of patient accounts and insurance data for completeness and accuracy as dictated by carrier procedures and provisions (e.g. Medicare, Medi-Cal, Blue Cross, etc.).
• Audits charges received from clinic sites.
• Interprets insurance program procedures and provisions in solution of routine patient billing inquiries and problems.
• Performs follow-up on balances due from carriers.
• Follow up on pending/denied claims, correcting and rebilling claims, posting payments and working aging.
• Following prescribed procedures, may record patient identification data and physician diagnosis, etc.
• Will record all payments and adjustments to computer systems and reconcile input as appropriate.
• Will update and maintain billing and provider manuals in a timely fashion.
• Will inventory supplies and anticipate needed supply items.
• Performs other routines and duties as requested.