Senior Billing Specialist

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