Description
OUR MISSION
Wellness Equity Alliance is a national multidisciplinary health organization that designs and delivers integrated, community-based care for populations most impacted by health inequities. We do this through mobile and field-based models, providing medical care, behavioral health services, substance use treatment, harm reduction, and care coordination in nontraditional settings such as encampments, schools, reentry sites, and rural communities as well as with sovereign tribal nations. Grounded in trauma-informed, culturally responsive, and data-driven practices, WEA combines clinical expertise, lived experience, and advanced population health analytics to reduce barriers to care, improve continuity, and strengthen local systems. We have partnered with more than 60 public agencies, managed care plans, and community-based organizations across the U.S. to implement scalable, sustainable programs that are advancing health equity and improving outcomes for historically marginalized populations
We are known as Renegades, Rebels, Disruptors and Dreamers. If that sounds like you we want you on our team.
Purpose of the position
The Billing Specialist supports accurate and timely revenue cycle operations for outpatient services, ensuring compliant charge capture, claim submission, and reimbursement. This role partners closely with clinical, administrative, and payer stakeholders to resolve billing issues, reduce denials, and improve overall financial performance—while supporting equitable access to care through efficient, patient-centered billing practices.
Key Highlights
- Compensation Range: $25.00 - $27.40 an hour, with final compensation determined based on experience, qualifications, and role scope.
- Work Location & Expectations: This role requires daily in-person engagement at our Indio, CA CWI location.
- Professional Development: Opportunity to collaborate with cross-functional leaders across Behavioral Health, Medical, Street Medicine, Public Health, Rural Health, and Tribal Health initiatives.
Key Responsibilities
Core Billing & Claims
- Prepare, review, and submit outpatient claims (professional and/or facility) to commercial, Medicaid/Medi-Cal, and Medicare payers.
- Ensure accurate coding alignment (CPT, HCPCS, ICD-10) and charge entry based on clinical documentation.
- Monitor claim status and follow up on unpaid or denied claims in a timely manner.
Denials & A/R Management
- Investigate and resolve claim denials, rejections, and underpayments.
- Work assigned accounts receivable (A/R) queues to meet productivity and aging targets.
- Identify root causes of denials and escalate trends to leadership with recommendations.
Compliance & Accuracy
- Maintain compliance with payer guidelines, regulatory requirements, and organizational policies.
- Support internal and external audits by ensuring documentation and billing accuracy.
- Stay current on billing rules, payer updates, and coding changes.
Cross-Functional Collaboration
- Partner with front desk, clinical teams, and coding staff to resolve charge discrepancies.
- Communicate with payers and patients to clarify billing issues or missing information.
- Contribute to workflow improvements that enhance billing efficiency and patient experience.
Reporting & Process Improvement
- Track key billing metrics (clean claim rate, denial rate, days in A/R).
- Recommend process improvements to reduce errors and accelerate reimbursement.
- Support implementation of new billing tools, workflows, or payer requirements.
Requirements
Qualifications and Education Requirements
- High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
- 2–4+ years of outpatient medical billing experience (clinic, FQHC, or hospital outpatient preferred).
- Experience with Medi-Cal/Medicaid, Medicare, and commercial payer billing.
- Working knowledge of CPT, ICD-10, and HCPCS coding as it relates to billing.
- Familiarity with EHR/PM systems (e.g., Athena, Epic, NextGen, eClinicalWorks, or similar).
Preferred Skills
- Certification (e.g., CPC, CPB through AAPC or equivalent).
- Experience in multi-site or high-volume outpatient environments.
- Background in behavioral health, public health, or community-based care settings.
