Job description

About us

HERS Breast Cancer Foundation is a 501(c)3 nonprofit organization with the mission of supporting all individuals healing from breast cancer by providing post-surgical products and services regardless of financial status. Our assistance programs provide patients with products and services that help facilitate physical and emotional healing, and financial assistance for burdensome insurance co-payments. We support our work via fundraising, grants, donations, and retail sales. HERS operates locations in Fremont, Livermore, and San Leandro. In continuous operation since 1998, HERS is a “soft place to fall” for breast cancer patients during one of the hardest times in their lives.

We are a team of hard-working individuals who are passionate about supporting breast cancer patients and one another. Our culture is professional, warm and welcoming, and our values are communication, trust, respect, and team work.

This is an opportunity to be a part of a fast-paced, energetic environment where everyone works collaboratively to help each other succeed. The position primarily involves entering medical and insurance information into our system but has several other functions such as preparing reports, communicating with patients by phone and assisting in office administration tasks. Prior experience in medical billing is preferred.

General Job Description:

This role will be responsible for the overall billing generated by patient services at all three of our locations although the candidate will work from our Fremont location. The focus of this position is claims oversight, including but not limited to eligibility and verification of prescriptions and insurance pre-authorizations, generating, and submitting claims, and appealing denied claims. This position reports directly to the Director of Administration.

Essential Duties:

• Prepare, review, and transmit claims using billing software, including electronic and paper claim processing
• Electronic billing and submission, management
• Follow up with Medicare, partnership health plans, and commercial insurance companies regarding unpaid insurance accounts as identified through aging reports
• Process appeals online or via paper submission in a timely manner upon receipt of coverage denial and escalate appeals efforts for resolution with payer
• Assist with billing audit-related information
• Work closely with dedicated staff member(s) to obtain and approve accurate prescriptions and pre-authorizations prior to scheduling patient appointments
• Research and resolve payment discrepancies; includes addressing unpaid claims within standard billing cycle time-frame
• Accounts Payable utilizing QuickBooks (training is available, if needed)
• Other duties that may arise from time-to-time or as commensurate with title and position

Required Skills/Abilities:

• Knowledge of government payer guidelines (Medicare/Medi-CAL)
• Strong understanding of medical billing and explanation of benefits (EOB)
• Familiarity with CPT and ICD-10 Coding
• Familiarity with Medical Billing Software (knowledge of Cortex EDI is a plus)
• Salesforce and QuickBooks experience is a plus
• Understanding of medical and insurance terminology
• Strong attention to detail
• Computer proficiency, including Office Suite (Word, Outlook, and Excel)
• Ability to type a minimum of 40 WPM
• Excellent communication skills, both written and verbal
• Ability to efficiently multitask, meet deadlines, and complete work accurately in a fast-paced environment
• Must undergo Livescan fingerprinting process and pass background clearances
• Must possess valid California driver’s license and auto insurance.
• A clean driving record and reliable transportation are required

Education and Experience:

• College degree preferred; high school diploma or GED are acceptable
• A minimum of 1-3 years of recent experience in medical billing is required
• Must be proficient in Microsoft Suite; prior experience with POS (Intuit Point of Sale) and Salesforce is a plus.

Benefits: No Medical Benefits other than PTO (paid time off), Sick Time Off and employee discounts.

Job Type: Full-time

Pay: $23.00 - $26.00 per hour

Benefits:

• Employee discount
• Paid time off

Schedule:

• 8 hour shift
• Monday to Friday

Supplemental pay types:

• Bonus pay

Ability to commute/relocate:

• Fremont, CA 94538: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Are you willing to undergo a background check?

Experience:

• ICD-10: 1 year (Preferred)

Work Location: One location

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