Statement of Purpose
Under the direct supervision of the Health Center Operations Director. The Medical Biller I is responsible for supporting the revenue cycle by accurately preparing, submitting, and following up on medical claims for services rendered within a health center setting. This role ensures timely reimbursement while maintaining compliance with payer guidelines, FQHC billing requirements, and organizational policies. The Medical Biller I works collaboratively with clinical and administrative teams to resolve billing issues and support continuity of care.
Major Tasks, Duties and Responsibilities
Prepare and submit accurate claims to Medi-Cal, Medicare, and commercial payers in a timely manner
Review patient accounts for completeness, including insurance verification, coding, and required documentation
Monitor claim status and follow up on unpaid, denied, or rejected claims
Identify and resolve billing discrepancies, including eligibility issues and authorization requirements
Post payments, adjustments, and denials accurately into the practice management system
Assist with processing patient statements and responding to billing inquiries
Maintain knowledge of FQHC billing requirements, including PPS and wrap-around payments
Ensure compliance with federal, state, and payer-specific billing regulations
Communicate with front office and clinical staff to correct or clarify billing information
Maintain accurate and organized billing records for audit and compliance purposes
Support month-end close processes and reporting as needed
Participate in safety program to promote client and staff safety
Maintain professional boundaries and standards of conduct
Treat clients with respect, care, and concern at all times
Maintain health and safety standards within the facility
Recognize personal biases and demonstrate cultural sensitivity when working with diverse populations
Attend meetings, trainings, and participate in committees as assigned
Perform other duties as assigned
Medical Biller I Competencies and Performance Expectations
Ability to complete the above major tasks, duties and responsibilities
Ability to demonstrate professional judgment and decision-making
Ability to adhere to professional standards
Strong attention to detail and accuracy in data entry and claim submission
Ability to manage multiple task and meet deadlines in a fast-paced environment
Effective communication and problem-solving skills
Ability to maintain confidentiality and handle sensitive patient information
Team-oriented with a customer service mindset
Statement of Purpose
Under the direct supervision of the Health Center Operations Director. The Medical Biller II is responsible for performing advanced revenue cycle functions, including complex claim resolution, denial management, and ensuring accurate reimbursement for services rendered within a health center setting. This role supports timely reimbursement while ensuring compliance with payer guidelines, FQHC billing requirements, and organizational policies. The Medical Biller II works independently and collaboratively with clinical and administrative teams to resolve billing issues, improve processes, and support continuity of care.
Major Tasks, Duties and Responsibilities
Prepare, review and submit accurate claims to Medi-Cal, Medicare, and commercial payers in a timely manner
Perform detailed review of patient accounts for completeness, including insurance verification, coding, and required documentation
Monitor claim status and follow up on unpaid, denied, or rejected claims
Analyze and resolve billing discrepancies, including eligibility issues and authorization requirements
Identify denial trends and implement corrective actions in collaboration with internal teams
Post payments, adjustments, and denials accurately, ensuring appropriate follow-up and resolution
Assist with processing patient statements and responding to billing inquiries
Maintain knowledge of FQHC billing requirements, including PPS and wrap-around payments
Ensure compliance with federal, state, and payer-specific billing regulations
Communicate with front office and clinical staff to correct or clarify billing information
Maintain accurate and organized billing records for audit and compliance purposes
Support month-end close processes and reporting as needed
Participate in safety programming to promote client and staff safety
Maintain professional boundaries and standards of conduct
Treat clients with respect, care, and concern at all times
Maintain health and safety standards within the facility
Recognize personal biases and demonstrate cultural sensitivity when working with diverse populations
Attend meetings, trainings, and participate in committees as assigned
Perform other duties as assigned
Medical Biller II Competencies and Performance Expectations
Ability to complete the above major tasks, duties and responsibilities
Ability to demonstrate professional judgment and decision-making
Ability to adhere to professional standards
High level of accuracy and attention to detail
Strong analytical and problem-solving skills, with ability to identify trends and implement solutions
Ability to manage multiple task and meet deadlines in a fast-paced environment
Effective communication and problem-solving skills
Ability to maintain confidentiality and handle sensitive patient information
Team-oriented with a customer service mindset
Prerequisite Qualifications - HC Medical Biller I
The following are the qualifications required to perform the essential functions of this position. Qualifications may be subject to modification based on the Americans with Disabilities Act.
High school diploma or equivalent required.
One year of medical billing experience in a healthcare setting preferred, ideally within a community health center or FQHC environment.
Basic knowledge of CPT, ICD-10, and HCPCS coding, as well as familiarity with Medi-Cal, Medicare, and managed care plans is preferred.
Experience with electronic health records and practice management systems is highly desirable.
Must have valid California driver’s license and liability insurance if driving a personal or company vehicle on BHS business.
Vision, hearing, manual dexterity, and eye-hand coordination must be adequate for the performance of job duties. Able to sit at a desk, use a keyboard, write and physically perform other job duties. Able to move about the facility to observe clients and staff.
Ability to maintain confidentiality and comply with HIPAA regulations
Prerequisite Qualifications - HC Medical Biller II
The following are the qualifications required to perform the essential functions of this position. Qualifications may be subject to modification based on the Americans with Disabilities Act.
High school diploma or equivalent required.
A minimum of four years of progressively responsible medical billing experience in a healthcare setting is required, preferably within a community health center or FQHC environment.
Strong knowledge of CPT, ICD-10, and HCPCS coding, as well as familiarity with Medi-Cal, Medicare, and managed care billing required.
Experience with electronic health records and practice management systems is highly desirable.
Must have valid California driver’s license and liability insurance if driving a personal or company vehicle on BHS business.
Vision, hearing, manual dexterity, and eye-hand coordination must be adequate for the performance of job duties. Able to sit at a desk, use a keyboard, write and physically perform other job duties. Able to move about the facility to observe clients and staff.
Ability to maintain confidentiality and comply with HIPAA regulations
