Clinic Insurance Billing Clerk

Description

POSITION TITLE: Clinic Insurance Billing Clerk

Department: Clinic 

Reports to: Sr. Director of Revenue Cycle

Mission of Department: We are dedicated to caring for all that seek our service in a competent, compassionate and professional manner. We are committed to continually striving to improve the quality of the services we provide to our patients, community and fellow associates. 

Purpose of Position: Responsible for performing any and all business functions that lend themselves to the creation, submission and reimbursement of insurance claims. 

Essential Functions:

1. File, submit and correct insurance claims. 
2. Post any and all charges, payments, denials and adjustments in our EMR.
3. Correct and resubmit any denied claim that can be corrected. 
4. Answer and resolve any insurance correspondence regarding a claim, immediately after that correspondence is received. 
5. Work activity reports to follow-up on all claims that have been billed but not paid. 
6. Answer patients’ billing questions regarding claims, claim payments, or account balances. 
7. Perform any and all functions not included in this list that are instrumental in creation, submission and reimbursement of insurance claims. 

The preceding functions have been provided as examples of the types of work performed by employees assigned in this job classification. Management reserves the right to add, modify, change or rescind work assignments and to make reasonable accommodations as needed.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skills and /or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Requirements

Additional Responsibilities:

1. Notifies the Clinic Billing Manager of any problem claims, unusual claim payments or adjustments. 
2. Assoicate will fill-in as a Clinic Receptionis as needed – while acting as a Clinic Receptionist, the associate will perform all essential functions of that position. 
3. Attends in-services and department meetings as required by SCH and management. 
4. Maintains patient confidentiality. 
5. Follows all Clinic policies and procedures. 
6. All individuals in this department are expected to treat patients under the direction of the physicians and in compliance with the wishes of the patient/customer and family members as long as it does not conflict with the physician’s orders and is in the best interest of the patient/customer- at no time should the personal interests and beliefs of a staff member interfere with the treatment and care a patient/customer receives.
7. Assumes other duties as requested by Management. 

Education, Qualifications, Experience:

High School diploma or GED

Rural Health Clinic billing experience preferred

Personal Characteristics: Friendly, compassionate, high-energy, time-oriented, well-organized, able to do multifaceted tasks, neat in appearance, excellent communication skills, independent and has a vision to see what needs to be done.

Knowledge, Skills, and Abilities: ICD-10 coding, CPT- 4 coding, able to use medical software & charge master, referral base for each medical staff personnel, scheduling practices for all medical staff, balancing of cash drawer, data entry.

Equipment: Computer, telephone (switchboard), paper shredder, postage machine, typewriter, calculator, printers, copiers, fax machine. 

Expectation of Service: This is a non-exempt 40 hour per week position. Regular and punctual attendance is required.*

*Overtime may occasionally be required in order to complete assignments that are given by the Clinic Billing Manager. 

Physical Requirements: This position requires continual sitting and typing at a computer terminal, answering phone calls, some walking, twisting, bending, stooping, and lifting of up to 25 pounds.