BILLING SPECIALIST

Full Time
Lancaster, PA 17603
Posted
Job description

Our Mission, Vision, & Model of Care

At Union Community Care, our purpose is to spark equity through patient-led healthcare that welcomes and strengthens our communities by integrating body, mind, and heart through 360 care – urgent sick care, behavioral health support, social support, family medical care, dental care, and a pharmacy —all in the same area or nearby our 11+ locations throughout Lancaster & Lebanon.

We envision vibrant and healthy communities supported by inclusive healthcare that embraces each patient’s unique culture, needs, and values, and emboldens them to make healthful choices that fuel their well-being and the well-being of others.

We believe in whole health. This means we address and heal disease but equally important, we work at the causes of the causes, the social ills that must be addressed to achieve true equity.

We listen, learn, and embrace the complex lives and unique strengths of our patients, and we work hard to break down all barriers to care. This means we look through a grassroots lens. We connect with our community because we are our community. Each of us is a neighbor, a friend, a family member, and together, we are a trusted community health center.


What it means to be a Federally Qualified Health Center

Union Community Care is part of a larger movement of Federally Qualified Health Centers (FQHCs), which are community-based, non-profit organizations that provide a full range of primary and preventive healthcare to their communities.

FQHCs are created by individuals in a community coming together with a mission to improve access to healthcare for those who are looking for a health home, those who don’t have health insurance, those who are under-insured, and those who are under-resourced, medically underserved and vulnerable. Every FQHC is different, but they all care for patients in a hyper-local, culturally-welcoming, and free-to-be setting.

FQHCs are vital resources in any community, and uniquely offer discounted rates or fees for medical and preventive dental services, 340B program savings on medications, and good faith estimates.

JOB SUMMARY

The Billing Specialist is an integral part of Union Community Care to ensure correct claims submission and payment of those claims. The Billing Specialist is also responsible for all other functions as assigned by the Revenue Cycle Manager.

SPECIFIC JOB DUTIES

  • Assist the Medical Charge Entry Billing Specialist to complete data entry processes of visits to ensure timely month end closing processes and claims processing.

  • Payment Posting for all Dental visits

  • Communicate with applicable staff regarding open medical claims to get resolved timely

  • Work claim holds, appeals and re-submission when necessary.

  • Assist with Payer claims processing issues

  • Create and submit Dental claims per payer requirements, either electronic or via paper.

  • Prepare Dismissals Letters for non-payment

  • Assist Insurance Verification Specialist to determine coverage for medical patients.

  • Communicate to staff of findings if patient is not eligible to be seen by Union Community Care staff.

  • Explain account balances to patients, reviewing sliding fee policy as appropriate, set up payment plans, and verify/update patient demographic information as appropriate.

  • Assists in various billing office positions as required

  • Perform other work-related duties as assigned

POSITION REQUIREMENTS

  • High School Diploma or G.E.D.

  • Excellent telephone communication skills

  • Good basic computer skills

  • Good basic math skills

  • Ability to communicate in English fluently – including speaking, reading, and writing

  • Good interpersonal skills

  • Honor patient confidentiality

ESSENTIAL FUNCTIONS

In order to fulfill the requirements of this position, duties 1-11 are considered essential functions of the job.

ORGANIZATIONAL INVOLVEMENT

This position is required to participate in mandatory all staff meetings, team meetings and trainings.

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