Billing Clerk

Responsible for entering and coding patient services into a computer system (EHR) and generating invoices to be sent to the patient. Handles insurance claims, performs collections duties and sorts and files paperwork. Responsible for collecting deductibles and co-pays, up front, during patient visits. This position will also assist patient account representatives.

Essential Duties and Responsibilities:

• Collect, post, and manage patient account payments.
• Submit claims to private insurance, Medicare and Medicaid.
• Prepare and review patient statements.
• Review delinquent accounts and call for collection purposes.
• Process payments from insurance companies and post.
• Code patient services and enter into computer.
• Sort and file paperwork.
• Ensure healthcare facilities are reimbursed for all procedures.
• Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding.
• Use computers to read and organize charts.
• Follow up to see if a claim is accepted or denied and if denied, investigate rejected claim to see why denial was issued.
• Demonstrates knowledge of, and supports, hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.
• While the majority of billing will be physician billing, will backup billing for hospital.
• Backup Patient Account Representatives by answering questions for customers on bills and payments.
• Protects patient privacy and confidentiality in accordance with HIPAA and privacy laws.
• Ensures patient satisfaction, including troubleshooting when there is a complaint and developing process improvements to prevent reoccurrences.
• Demonstrates clear ownership of workplace and patient safety.
• Report mistakes, near misses, adverse events and quality and safety concerns.
• Participates in the development and implementation of safety and quality improvement activities.
• Other duties as may be assigned.

Job Requirements

Education: High School diploma or GED required; Associates preferred. Or, specialized training in Insurance billing and data entry. Preferable to have coding (ICD-10) training and experience.

Licensure/Certification:

Experience: Requires at least one year experience in patient accounting or related third-party billing/collection with in-depth knowledge of specific third-party payer requirements including knowledge of Medicare/Medicaid regulations and billing requirements. Also requires extensive knowledge, understanding and proper application of contractual information concerning the numerous payers as they relate to allowables/discounts/per diems. Ability to file insurance claims by hard copy and electronically. Must show maturity in dealing with co-workers. Good verbal and written communication skills are essential. Ability to effectively communicate and interact with physicians, colleagues, hospital staff, patients, public, and third-party insurance personnel. Ability to work under stress, with interruptions and deadlines.

Physical Requirements: Frequent sitting and long periods of data entry. Occasional bending, stooping, and reaching. Occasionally lift 25 lbs. Good visual acuity.