Medical Billing Specialist

Hawai’i Health & Harm Reduction Center (HHHRC) provides harm reduction-focused services to marginalized populations in Hawai’i, including people living with and/or affected by HIV, hepatitis, substance use, homelessness, and the transgender, LGBQ, and the Native Hawaiian communities. HHHRC bridges gaps and helps individuals access essential resources such as housing, health care, entitlements, and treatment. We foster health, wellness, and systemic change in Hawai’i and the Pacific through outreach, care services, advocacy, training, prevention, education, and capacity building.

SUMMARY OF POSITION

The Billing Specialist is responsible for the agency’s service billing. Service billing includes collecting co-payments, maintaining billing software with accuracy, supporting the patient payment experience, and recording late payments. The Billing Specialist is also responsible for ensuring billing integrity for the Ryan White Part B (RWB) HIV/AIDS Program comply with HRSA’s monitoring standards.

This is a permanent, full-time, exempt, salaried position with HHHRC located in Honolulu, Hawaiʻi. Expected hours of work are generally between 8:00am to 4:30pm, Monday through Friday, with some evening and weekend attendance for required events. Salary is commensurate with experience.

REPORTING RELATIONSHIP:

Reports to: Finance Manager

Supervises: N/A

Collaborates: Behavioral Health, Ryan White and Clinical Services

ESSENTIAL DUTIES & RESPONSIBILITIES:

Patient Co-Payment

• Collect applicable co-pays/co-insurance/deductibles, post payments, provide receipts, make change, give applicable discounts, notify correct employees to post discounts, and balance daily batch.
• Follow up on collections, which includes calling patients to discuss past due payments, assisting patients with developing a reasonable payment plan, entering collection data into the electronic medical records system and the accounting system, and recording information about outstanding claims.

Medical Insurance Billing

• Scan and upload insurance payments into HHHRC’s electronic medical record (EMR).
• Process insurance refund requests that are not automated by the insurance carriers.

Ryan White (RWB) Billing

• Verify RWB eligibility is met for all clients in which services are being billed in the State’s HIV database, e2Hawaii.net (e2).
• Ensure all service entries being billed are complete and accurate. Reject any incomplete services and inform the HIV Director of all unapproved entries.

Behavioral Health (BH) Billing

• Review, authorize, and release service charges in the State’s Web Infrastructure for Treatment Services (WITS) system.
• Adjust encounters in WITS as needed to ensure successful billing submission.
• Generate a monthly utilization breakdown report that allocates WITS charges by agency departments/programs.
• Produce reports on WITS billables for BH leadership.
• Handle billing for the community integration services (CIS).
• Perform additional duties as needed and assigned. Duties are subject to change with ample notice.

GENERAL RESPONSIBILITIES:

• Contribute to a safe, creative, enthusiastic, and cooperative working environment for all.
• Work as a team with other staff and support team members.
• Maintain appropriate professional and ethical standards while serving as a representative of HHHRC.
• Observe and comply with rules and regulations – such as HHHRC Code of Conduct, Drug-Free Workplace – and other administrative policies of HHHRC.
• Abide by all policies and procedures of the HHHRC Health & Safety Program and the Quality Management Program.
• Comply with HHHRC confidentiality policy, HIPAA requirements, cultural competencies, and rights to persons served, as well as CARF standards.
• Demonstrate steadfast understanding of, and commitment to, the Mission, Vision, and Values of HHHRC.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Indoors, air-conditioned office area.
• Long hours sitting using office equipment and computers, which can cause muscle strain.
• Regular use of computers keyboards, telephone, and operating office equipment.
• Essential physical activities: standing, sitting, walking, finger dexterity, seeing, hearing, speaking, reaching above, at, and below shoulder, and frequent gripping of an object.
• Occasional physical activities: stooping, bending, squatting, twisting body, and lifting.
• Occasional lifting and carrying of supplies and equipment (up to 25 pounds).

REQUIRED QUALIFICATIONS:

Knowledge/Skills/Abilities:

• Proficiency with Microsoft Office suite, (Word, Excel, Outlook, PowerPoint, SharePoint, etc.).
• Solid understanding of billing software and proficiency with electronic medical records.
• Excellent interpersonal, written, and verbal communication skills.
• Non-judgmental attitude and ability to respect the knowledge, actions, and feelings of others.
• Demonstrated ability to work productively, both independently and as part of a team.
• Ability to work well and thrive professionally in an atmosphere of significant diversity, working with marginalized populations.

Education/Experience:

• Bachelor’s Degree in Business, Health Care Administration, Accounting (or relevant field), or equivalent work experience.
• Three (3) years of experience in Medical Billing or any coding industry.

REQUIRED WORK CARDS/CERTIFICATIONS:

• COVID-19 Vaccination (recommended)
• TB Clearance
• Hep B Clearance and/or Vaccination
• Must pass Center for Medicare/Medicaid Services eligibility screening.

Hawaiʻi Health & Harm Reduction Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.