21890 Colorado AvenueP.O. Box 737 PH 559 693 -2462 San Joaquin CA 93660 FAX 559 693 -3005 JOB DESCRIPTION POSITION LEAD MEDICAL BILLING SPECIALIST REPORTS TO BILLING MANAGER POSITIONS SUPERVISED NONE CLASS REGULAR CAT FULL -TIME NON -EXEMPT BASIC FUNCTIONS Under the supervision of the Billing Manager this position oversees billing special ist staff members and requires substantial experience and understanding of the healthcare billing industry including ICD -10 CPT coding. Responsibilities entail capturing patient demographics entering reviewing and preparing patient and insurance data i nto the practice management system researching and verifying accuracy of billing data and the revision of coding errors including adjustments and denials. DUTIES AND RESPONSIBILITIES 1. Oversee the day -to-day functions for a group of billing specialists . 2. Responsible for reviewing patient logs demographic insurance eligibility and othe r activity to ensure billing is captured for all patients and completed accurately. 3. Monitor Insurance electronic claim billing process is completed successfully on a daily basis. 4. Report coding discrepancies to the Certified Coding Specialist Associate and Management team. 5. Assist with closing open encounters in order to timely close m onth and year end reporting 6. Oversee open credit balance report and resolve any refunds due 7. Stay up -to-date on current coding regulations and departmental policies. 8. Assist with third party payer and other audit request by compiling and organizing documentation. 9. Assist the coding and compliance team with the procedure manuals related to coding an d billing compliance. 10. Train new and current Billing Specialist on charge capture and coding process. 11. Generate Excel spreadsheets for special projects as assigned. 12. Monitors and reports to Management team and Certified Coding Specialist on matters related to coding compliance. 13. Oversee payment posting to ensure timely and accurate posting of patientpayer receipts. 14. Contribute to team effort by assisting other departments as needed and while maintaining confidentiality of VHTs business. 15. Work cooperatively with all staff members and outside sources in a professional manner to deliver a high level of service. 16. Follow applicable regulations Joint Commission OSHA HIPAA and CLIA. 17. Serves and protects the practice by adhering to professional standards policies an d procedures federal state and local requirements and The Joint Commission Accreditation of Healthcare Organization standards. 18. Observe and practice all VHT Patient Experience Service Standards as outlined in World Class Practices My Commitment to Ca re which I have read and signed. Practice CICARE when interacting with patients their families visitors or internal customers. 19. Practice CICARE phone etiquette during all phone interactions. 20. Always exercise courtesy whenever patients family members visitors and co -workers are present. 21. Respect privacy and dignity of our patients family members visitors and co -workers. 22. Maintain professionalism in the presence of patients their families visitors and co -workers. 23. Act as a role model verbally and be haviorally demonstrating skill enthusiasm positive problem solving commitment and loyalty to the profession and the organization. Job Description Lead Medical Billing Specialist Page 2 24. Perform other related duties which may be inclusive but not listed in the job description. MINIMUM QUALIFICATIONS 1. Associates degree or equivalent from two -year college or technical school Bachelors degree preferred. A minimum of three years of work experience in a related field is necessary. 2. Strong knowledge of ICD -10 CPTHCPCS coding guidelines 3. Be self -motivated and have the ability to prioritize work and meet deadlines 4. Good judgment and decision -making skills 5. Strong ethics and a high level of personal and professional integrity 6. Computer literate and highly proficient in using MS Office 7. Strong customer service skills preferably within a service industry 8. Knowledge of federal laws and regulations affecting coding requirements 9. Knowledge of billing practices required FQHC billing preferred 10. Knowledge of Electronic Health Records - NextGen experience strongly preferred 11. Extensive knowledge of official coding conventions and rules established by the American Medical Association AMA and the Center for Medicare and Medicaid Services CMS for assignment of diagnostic and procedural codes 12. Excellent oral and written communicat ion skills - be able to provide information in a clear and concise manner good interpersonal skills 13. Fluent conversational EnglishSpanish strongly preferred 14. Ability to be flexible with work schedule and available to work at all site locations 15. Must have ow n transportation valid California Drivers License and current proof of automobile insurance coverage 16. Demonstrated ability to provide world -class patient experience using CICARE principles and practices. Ability to be proactive and to go above and beyond the call of duty take initiative to provide a world class patient experience in all encounters via email phone or in person. TYPICAL WORKING CONDITIONS The office setting is a normal work environment. Occasionally work during early morning eveni ng or weekend. May be subject to temperature variances in the office. TYPICAL PHYSICAL DEMANDS Requires sitting standing or walking for up to eight hours a day. Some bending stretching or reaching may be necessary. Lifting up to 40 pounds may be requ ired on occasion. Vision must be correctable to 2020 and hearing must be in the normal range for telephone contact. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performin g the essential functions of this job. R easonable accommodations may be made to enable individuals with disabilities to perform the essential functions. I the employee understand the responsibilities and standards of my position as listed above and I agree to fulfill them to the best of my ability. I understand I am an at -will employee and can be terminated at any time with or without cause. I also understand the Valley Health Team Inc. will not be responsible in any manner for terminations which are due to defunding of Federal or State Contracts. I also agree that the VHT Board of Directors have the right to modify the Personnel Policies which govern my employment at any time. This organization is an Equal Opportunity Employer. It is our polic y to comply with all applicable state and federal laws prohibiting discrimination in employment based on race age color sex religion national origin or other protected classification. ____ Employees Signature Date