Billing Representative
$54,080–$60,778 year
On-siteHayward, California, United States
Hayward, California, United StatesOn-siteFull Time$54,080–$60,778 yearMedium
Full TimeMedium
Job Summary
Process and maintain third-party and self-pay billing for Tiburcio Vasquez Health Center, including claims submission, adjudication, and denial management across Medicare, Medi-Cal, and private insurance. Establish and update patient accounts, develop appeal documentation for denied remittances, and monitor workflow across multiple sites to ensure timely submissions and accuracy. Collaborate with providers, medical assistants, and Finance teams to optimize revenue cycle goals while safeguarding patient confidentiality. Work Monday through Friday with occasional evening or Saturday hours.
Required Qualifications
- current knowledge of billing practices, procedure codes, and payer requirements
- ability to meet or exceed TVHC's Service Excellence Standards
- ability to effectively communicate with management and operational staff
- ability to maintain confidentiality to safeguard patient information and records
- ability to work collaboratively with providers, medical assistants, front desk staff, and Finance and IT teams
- ability to perform timely follow-up on denied Remittance Advice/Explanation of Benefits (RA/EOB) for all insurance claims
- ability to develop well-supported, patient-specific appeal documentation for payers
- ability to establish and maintain patient accounts in accordance with TVHC policies and procedures
- ability to monitor workflow across multiple sites
- ability to identify opportunities for process improvement and operational enhancement
- ability to escalate compliance, red-flag activity, and fiscal concerns to appropriate leadership
- ability to apply a solutions-focused approach to billing-related concerns and complaints
- ability to maximize reimbursement under all accepted insurance plans and self-pay arrangements
- ability to ensure the timeliness, accuracy, and integrity of billing operations
- ability to support the optimization of department performance in areas including claims submission, adjudication, denial management, and follow-up on outstanding receivables
- ability to provide analytical support to help establish and achieve revenue cycle goals and objectives
- ability to work under the direct supervision of Billing/Revenue Cycle leadership
- ability to work with fiscal oversight from the Finance and Accounting Department
- ability to support Medicare, Medi-Cal, private insurance, managed care, and other third-party billing and collections
- ability to work across all TVHC providers and facilities
- ability to work Monday through Friday with occasional evening or Saturday hours
- ability to work 40 hours per week
- ability to work full-time
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