Medical Billing Specialist

The didgáli Wellness Center is looking for a highly motivated Medical Billing Specialist to join our integrated care clinic that combines primary care, behavioral health, and opiate treatment under one roof. The Billing Specialist is responsible for submitting medical claims to insurance companies and payers such as Medicare and Medicaid. This position requires strong computer and business office skills, critical thinking and the ability to produce and present detailed billing activity reports.

Some of Our Benefits Include:

• Competitive base compensation, with annual reviews for increase


• Comprehensive health, dental, and vision insurance with; no, to little out-of-pocket costs.


• Employer-paid life insurance, AD&D, short- and long-term disability.


• 401(k) Retirement Plan with up to a 4% employer contribution.


• 4+ weeks of Paid Time Off (PTO).


• 12 paid holidays observed.


• Great working hours for work-life balance.


• Onsite snacks and meals during employee recognition events (often times monthly).


• Generous professional development and reimbursement for required professional license and certification renewals.

What you’ll do:

• Prepare, review, and transmit claims using billing software, including electronic and paper claim processing.


• Responsible for accurate medical coding, charge entry, claims submissions, payment posting.


• Follow up on unpaid claims within standard billing cycle timeframe.


• Check each insurance payment for accuracy and compliance with contract discount.


• Call insurance companies regarding any discrepancy in payments as necessary.


• Identify and bill secondary or tertiary insurances.


• Investigate and appeal denied claims.


• Answer all patient or insurance telephone inquiries pertaining to assigned accounts.


• Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues.


• Maintain contacts with other departments to obtain and analyze additional patient information to document and process billings.


• Ensure that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, following Federal, State, and payer regulations, guidelines, and requirements.


• Keep up to date with carrier rule changes and distribute the information within the practice.


• Understand and remain updated with current coding and billing regulations and compliance requirements.


• Maintain a working knowledge of all health information management protocol such as HIPAA and all health regulations.

Must Haves:

• Thorough understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare, strong knowledge of Washington and Federal payer regulations.


• Possess excellent negotiation skills, including the tact required for securing payment or discussing patient's finances, and enjoy working in a health care setting.


• Excellent customer service skills for interacting with patients regarding medical claims and payments, and for communicating with insurance payers to resolve issues.


• Ability to work in a cross-culture environment, understands the social and cultural context of the patients at the didgalic Wellness Center. Understands the role of trauma, historical, community, family, and personal experience in wellness and recovery. 


• Ability to multi-task and work effectively with fellow employees, clients, and patients.


• Understands and adheres to state (RCW, WAC) and federal confidentiality regulations (42 CFR part 2).


• Must possess strong computer and software skills (MS Office products and customer database systems).


• High School Diploma or equivalent required.


• Medical billing and coding certification preferred.


• 2+ years of experience as a certified coder required.


• Prolonged periods of sitting at a desk and working on a computer.


• Must be able to lift up to 15 pounds at times.


• Ability to pass an extensive background check and pre-employment drug screening.


• Tribal affiliation a plus!