Senior Billing Specialist at Roots Community Health Center

Oakland, California, United States -

Full Time

Start Date

Immediate

Expiry Date

02 Sep, 26

Salary

32.0

Posted On

04 Jun, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Accounts Receivable Follow-up, Denial Management, Payment Posting, Medical Billing, Insurance Verification, AdvancedMD, Electronic Health Records, Medical Terminology, Analytical Skills, Problem-solving, Staff Training, Compliance Auditing

Industry

Hospitals and Health Care

Description

Description Position Summary: The Senior Billing Specialist is responsible for accounts receivable follow-up, denial management, and payment posting to maximize reimbursement and ensure timely resolution of outstanding claims. This position focuses primarily on Alameda Alliance, Medicare, and Medi-Cal claims and supports training of front desk staff, new hires, and interns as needed. The position reports directly to the Billing Manager. Duties and Responsibilities: Review paper and electronic remittance advices (ERAs), explanation of benefits (EOBs), and denial notices. Post insurance payments and contractual adjustments accurately in AdvancedMD. Conduct accounts receivable follow-up on billed claims to ensure timely payment. Research denied or underpaid claims and take corrective action toward resolution. Correct claim errors and resubmit claims to payers as appropriate. Investigate payment delays and unresolved claims to maximize reimbursement. Review and update patient demographics, insurance plans, and carrier information. Verify insurance eligibility and PCP assignment when necessary. Maintain accurate demographic and insurance information in the electronic health record and billing system. Monitor and report denial trends and reimbursement issues to the Billing Manager. Participate in internal chart audits, billing audits, and compliance activities. Implement payer billing guidelines, policies, and procedures. Support front desk training as needed, including the development of tip sheets and desk references to assist the Patient Services Department. Assist with onboarding and training of new hires and interns as needed. Attend staff meetings, supervision sessions, and required trainings. Complete assigned documentation and reports in a timely manner. Perform other related duties as assigned. Requirements Qualifications and Competencies: High school diploma or equivalent required; Associate's or Bachelor's degree preferred. Minimum of three (3) years of experience in medical billing, payment posting, or accounts receivable follow-up. Experience working with Medicare, Medi-Cal, and managed care payers, including Alameda Alliance for Health. Strong knowledge of insurance denials, appeals, and payer billing guidelines. Proficiency in Electronic Health Records and practice management systems, preferably AdvancedMD. Knowledge of medical terminology and healthcare reimbursement principles. Strong analytical, organizational, and problem-solving skills. Ability to train and support staff in registration and billing-related workflows. Experience working in a nonprofit or community health center setting preferred.

Responsibilities

The Senior Billing Specialist manages accounts receivable, payment posting, and denial resolution to maximize reimbursement for Medicare and Medi-Cal claims. Additionally, the role provides training and support to front desk staff, new hires, and interns.