Health Center Medical Biller I/II

DescriptionStatement 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