Neighborhood Healthcare · 1 week ago
Insurance Biller II
Escondido, CA
Full-time
Hybrid
Entry, Mid Level
$25.67/hr - $32.11/hr
2+ years expNeighborhood Healthcare is a private, non-profit community health organization dedicated to improving the health and happiness of the communities it serves. The Insurance Biller II is responsible for processing and supporting the medical billing process, ensuring compliance with coding processes and managing billing inquiries.
Health Care
Responsibilities
Reviews progress notes to obtain payer measures and requirements information for proper submission compliance
Reviews and obtains required information for missing and incomplete billings, such as missing DX, procedure codes, payer specific needs, eligibility screening, and coverage verification
Creates and submits claims for clean billable charges and statements in compliance of correct coding initiatives and billing industry requirements
Processes and monitors system claim status categories to ensure all transactions are captured for month end close
Registers patients in the payment portal, as needed
Reviews, processes, and obtains patient eligibility information to ensure accuracy and completion, including acquisition of authorization numbers, as needed
Applies discounts to billing statements for patients eligible for the Sliding Fee Discount Program (SFDP), as needed
Posts patient and insurance payments to account balance adjustments and write offs, as assigned
Monitors and reports insurance payment denials, including coding issues and benefit changes
Reviews and processes aging claims and denials, including claim tracers, corrected claim submissions, appeals, and consistent revenue flow
Reviews and processes refunds and insurance recoupment requests
Submits patient statements on cash accounts, as needed
Processes monthly collection accounts for collection agencies, as needed
Supports site related phone lines and voicemails; returns calls, as needed
Discusses escalated billing inquiries with patients, third party payers, and/or sites to resolve account questions and/or problems
Negotiates payment plans with patients, as needed
Provides excellent customer service to patients and escalate issues to a supervisor, if needed
Responds to site, insurance, and patient correspondences related to billing in a timely manner
Attends billing training and team meetings
Qualification
Required
High school diploma/GED required
Two years of medical billing experience in a healthcare environment required
Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
Knowledgeable about and experience with insurance eligibility processes and coverage guidelines for multiple carriers
Knowledgeable about and experience with billing compliance standards
Knowledgeable on uses of CPT, HCPCS, and ICD codes
Knowledgeable with insurance payers, funding sources, and managed care plans
Ability to successfully manage multiple tasks simultaneously
Excellent planning and organizational ability
Ability to work as part of a team as well as independently
Ability to work with highly confidential information in a professional and ethical manner
Preferred
Medical Billing or Coding Certification from an accredited school preferred
Experience working in a specialty and/or FQHC community clinic is preferred
Company
Neighborhood Healthcare
Neighborhood Healthcare is a health care center that offers senior care, dental care, behavioral health, psychiatrist, and therapist.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
$0.5MKey Investors
The Conrad Prebys FoundationU.S. Department of Health & Human Services
2023-06-26Grant· $0.5M
2021-11-11Grant
Leadership Team
Rakesh Patel, MD, MBA, FACHE
Chief Executive Officer
Jeff Glenn
Chief Operating Officer
Recent News
2026-01-14
2025-11-14
San Diego Business Journal
2025-05-06
Company data provided by crunchbase