The Electronic Billing Specialist, under general supervision, performs work of considerable difficulty in assisting with the administration of the Health Department’s central billing office management program. This role has the responsibility for reviewing, researching, analyzing and processing all paper and electronic EDI billing files to Medicaid/Managed Care Organizations, Medicare, private insurance and all other revenue sources through our clearinghouses, Viatrack and InMediata. Additionally, they ensure accurate records are kept for all billing activity to ensure the agency complies with all appropriate regulations as required and provides various patient management reports as needed.
EXAMPLE OF DUTIES
Processes and analyze electronic claims through NextGen, Viatrack, InMediata or Value Options systems and act upon the findings in a timely manner.Process paper claim.Analyze and resolve all claim edit errors using Viatrack and NextGen.Review and process all private patient statements in NextGen and transfer data accurately to the central printing office at the county for printing and mailing.Create patient management reports using the NextGen system.Analyze and resolve accounts receivable aging issues.Use Microsoft Excel to create spreadsheets to assist in the analysis of patient data.Analyze and correct patient sliding fee adjustments in NextGen as needed.Trace the transactions through NextGen from charge entry through claim creation as part of problem resolution. Differentiate between clearing house rejections and payer rejections by frequently working within the Viatrack clearing house environment.Resolve billing inquiries from internal and external customers.Gives appropriate information referrals and documents as necessary.Keeps thorough records of all activity including reporting and tracking of billing adjustments or corrections.Participates in staff meetings, in service trainings, and seminars to facilitate professional growth and maintain licensure if required.Involvement in quality improvement activities on an ongoing basis.Assists with other projects and duties as assigned.Schedule: 37.5 hours per weekMonday – Friday (9am – 5pm)
Completion of a high school diploma or G.E.D. certificate required. Associate’s Degree or certification in medical technology or accounting is preferred. Three years experience in a medical billing or accounting office setting is preferred.Bilingual is preferred.
As the largest human service provider in Lake County, we believe that services must be available without barriers. No residents are turned away due to the inability to pay. We believe in providing services in an environment of mutual respect, free of discrimination or bias. Whether assuring accessible and effective care, impacting policy, or assessing and monitoring risks, the Lake County Health Department and Community Health Center has been an essential part of the public health system in Lake County for 60 years. We are looking for passionate, qualified team members, who can help make a difference in our agency, and most importantly, in our community. As a public health department, we believe in the science, data, and power of vaccines, like the influenza and COVID-19 vaccines, to protect against and prevent illness. Therefore, we require all Health Department staff to receive the primary series of the COVID-19 vaccine as well as the annual influenza vaccine unless they have an approved medical or religious exemption. Any offer of employment is conditioned on the successful completion of a background screening, drug and alcohol testing and may include a pre-employment medical exam.The Lake County Health Department and Community Health Center is an Equal Opportunity Employer. We evaluate qualified applicants without regard to race, color, religion, sexual orientation, gender identity or gender expression, national origin, disability, veteran status, and other protected characteristics.