INSURANCE OFFICE CLERK

Description

Prepares and verifies statements and bills insurance carriers and/or patients involved in
outpatient/inpatient services. Notifies and maintains self-pay accounts for all hospital services
rendered.

1. Provides timely, thoughtful and accurate computations of hospital charges that are covered
under a Blue Cross insurance contract, Medicare provisions and miscellaneous insurances or
self-pay for services provided to patients on an outpatient/inpatient basis, including the
preparation of bills to be mailed directly to the patient, the completion of insurance forms, and
other types of correspondence required in connection with the operation of this section, as well
as the maintenance of files in accordance with established practice.
2. Whereas necessary, calls the patient or writes for explanation concerning complaints, relevant
data or additional information. Initiates investigations on accounts where payment has not been
received by the hospital. On accounts where coverage has been denied, or due to lack of
sufficient insurance information or because the patient has no insurance coverage, the
incumbent submits the initial bill and follow up bills to the patient. Following established
procedure, prepares itemized statements for patients requesting same when account has
received full payment.
3. Processes any payments that have been received for an account, insuring that accurate
information concerning the receipt of this money (check or cash) is credited to the proper
account and recorded properly in other official hospital records. For example: Processes
checks and cash payments received on self pay accounts, processes bad debt payments when
received from collection office, files outpatient self pay accounts.
4. Performs a variety of clerical duties in connection with the preparation of reports pertaining to
the departmental functions, itemized statements for insurance carriers, transferring insurance
payments or charges and investigations for payments and contacts doctors for forms that their
office has not processed.
5. Files inpatient I outpatient dax cards.
6. Bill outpatient DPA accounts.
7. Processes DPA checks.
8. Answers all telephone calls and personal questions regarding patient bills, including the
answering of questions that are posed from patients who visit the hospital concerning
outpatient/inpatient charges on services rendered, as it pertains to them. Refers all problems to
Credit Manager or Supervisors.
9. Performs a wide variety of clerical duties related to various types of billings in other sections of
the office, as required or requested.
10. Logs transactions as directed.
 

Qualifications

Equivalent to high school plus up to one year of additional education
Over three months up to and including one year experience.