Responsibilities
This role blends front office coordination with billing, coding, and revenue cycle responsibilities across the full patient visit cycle.
Pre-Visit
- Reviews upcoming patient account balances at least one week ahead of scheduled visits and follows up on outstanding balances across a family's full account.
- Verifies insurance coverage in advance of each visit and resolves any issues before the appointment.
- Coordinates primary care provider (PCP) changes with insurance plans and patients.
Visit
- Verifies insurance on the date of service and maintains accurate, up-to-date insurance records for each patient.
- Collects visit payments and outstanding balances, and processes payments accurately.
- Provides backup support for check-in and check-out, including scanning insurance cards and scheduling follow-up appointments.
Post-Visit
- Posts visit charges daily and posts payments from insurance remittances and paper EOBs
- Follows up with patients and families on outstanding account balances.
- Reviews and resolves payment discrepancies and exceptions.
Billing & Accounts Receivable
- Manages accounts receivable, including insurance appeals, denials,and claim follow-up to maximize collections.
- Maintain thorough documentation of billing transactions and coding activities in accordance with healthcare regulations.
- Submits historical claims and supports quality- and performance-based billing programs.
Administrative & Communication
- Coordinates with community partners to partner with our team to provide patients and families with additional resources.
- Provides back up to answer incoming phone calls and respond to patient messages in a timely manner.
Requirements
- Bilingual fluency in Spanish (spoken and written) is mandatory for this role.
- Minimum of three (3) years of front office experience in medical billing and coding.
- Strong, demonstrated experience with Revenue Cycle Management (RCM), including insurance verification, claims submission, and payment posting.
Preferred
- Current Basic Life Support (BLS) certification.
- Experience working in a pediatric care setting.
- Familiar with IEHP P4P
Additional Qualities We Value
These qualities matter to our team and will be explored throughout the interview process:
- High integrity and strong customer service skills.
- Positive energy, patience, and the ability to stay calm while adapting to a variety of situations.
- A genuine advocate for patients who works collaboratively with the care team.
- Friendly and respectful with children, their families, and colleagues.
- Goal-oriented with strong problem-solving instincts.
- Excellent attention to detail, organizational skills, and time management.
- A willingness to learn, take initiative, and grow within the role.
- Interest in leadership and advancing pediatric and administrative knowledge.
Invested in Your Well-Being
As a medical practice, we believe in building strong relationships not only with our patients but also with our team members. We are proud to offer a comprehensive benefits package designed to support your health, your future, and your work-life balance.
- Health & Wellness: Comprehensive Dental and Vision coverage to keep you and your family healthy.
- Rest & Rejuvenation: Generous Paid Time Off (PTO) and dedicated Paid Sick Time, plus 8 observed holidays throughout the year.
- Future Security: A 401(k) retirement plan to help you reach your long-term financial goals.
Work Schedule
Our standard office hours are Monday through Friday, 8:00 am to 5:00 pm.