Are you passionate about helping others and looking to grow your career in a supportive, mission-driven environment? Join one of Northern Nevada's Best Places to Work – Northern Nevada HOPES!
PURPOSE: Our Medical Biller seeks opportunities to capture maximum revenue.
JOB SUMMARY: The Medical Biller is responsible for ensuring that revenue realized is maximized for the agency through efficient and timely processing of third-party claims. The Biller engages in reporting and reconciling of lab payments.
ESSENTIAL FUNCTIONS: Claim Submission and Payer Maintenance | Denial Response | Patient Assistance
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Claim Submission and Payer Maintenance
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Manages the submission of claims for assigned payers by scrubbing and transmitting to the clearinghouse, monitor claim status, correct errors and resubmit as necessary.
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Identifies assigned payer issues and follow up with third party payers to ensure timely resolution.
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Processes the Medicaid WRAP file monthly ensuring submission is within the deadline.
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Reviews daily bank statements and post payments either electronically or manually.
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Review mail daily for any payments or correspondence.
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Denial Response
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Monitors claim status to ensure timely response to rejected and denied claims.
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Reviews denials for assigned payers and record denial reason in appropriate location.
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Reviews patient accounts and insurances monthly to ensure accounts receivable is accurate following recommended writeoffs per agency policy.
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Processes on a daily basis insurance and patient payments, reconciling payments to the daily bank deposit.
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Call insurances or check insurance portals and identify incorrect denial reason and appeal as needed.
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Patient Assistance
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Assists the patient population with concerns/questions regarding their account.
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Processes patient and insurance refunds per policy.
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Reviews patient eligibility on a daily basis.
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Reviews patient balances based on daily clinic schedule and initiate collection activities via check in process.
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Models exemplary service recovery tools with vendors, staff and patients.
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Collect patient balances via phone, mail or in person.
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Generate patient’s good faith estimates and mail out daily.
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Assist patients with payment plans.
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Review old patient accounts and write off as bad debt per policy.
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Other Duties
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NDOC reconciliation
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May need to collaborate with other departments.
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Billers may be assigned monthly special projects.
At HOPES, we’re more than just a healthcare provider — we’re a team of changemakers dedicated to delivering affordable, high-quality medical, behavioral health, and support services to everyone in our community.
Be part of a team that’s transforming lives every day. Your work will directly contribute to improving health outcomes and building a stronger, healthier Northern Nevada.
At HOPES, every team member is encouraged to bring their unique talents and perspectives to the table. Collaboration and innovation are at the heart of everything we do.
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Career Growth & Development
We invest in your future by offering a mentorship program, leadership and soft-skills training, networking opportunities, and support for continuing education.
100% employer-paid health insurance
3 weeks of PTO in your first year
12 paid holidays annually
Paid Parental Leave (after 12 months)
24/7 Employee Assistance Program
Click HERE to view a full list of benefits
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High School Diploma or Equivalent required.
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Experience with Microsoft Excel required.
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General knowledge of billing practices for a Federally Qualified Health Center (FQHC) preferred.
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Previous experience in electronic medical billing preferred.
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Bilingual preferred.
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Due to real and potential conflicts of interest that exist when HOPES Behavioral Health providers render services to their coworkers, it is HOPES’ policy (Policy HR0005) that HOPES employees may not access HOPES Behavioral Health Services. For the same reason, current Behavioral Health patients/clients cannot be employed by HOPES. Accordingly, you hereby acknowledge and understand that if you are receiving services from a HOPES Behavioral Health provider at the time you are offered and accept employment with HOPES, you have the option of rescinding your acceptance of employment or finding a new behavioral health provider outside of HOPES before starting employment with HOPES.
Northern Nevada HOPES is a nonprofit community health center operating two clinics and a transitional housing community in the heart of Reno, Nevada. Our one-stop-shop integrated care model helps us meet our patients where they're at and make medical and behavioral health care more accessible to medically under-resourced populations. HOPES is a proud member of the Northern Nevada Best Places to Work Hall of Fame, as well as a recipient of the Best Places for Working Parents award and the Candid Platinum Seal of Transparency for nonprofits. Northern Nevada HOPES is a Federally Qualified Health Center and Patient Centered Medical Home. Northern Nevada HOPES is an Equal Opportunity Employer. We prohibit discrimination on the basis of race, color, religion, sex, sexual orientation, gender, gender identity, parental status/pregnancy, national origin, age, physical or mental disability, genetic information, or veteran status in all employment practices.
