Insurance Billing Clerk

Insurance Billing Clerk

JOB SUMMARY

Under the direct supervision of the Manager of Patient Financial Services, this position is primarily responsible for all processes necessary to submit claims to insurance companies for hospital services. Strives for superior performance by consistently providing a product or service to leadership and staff that is recognized as ultimately contributing to the patient and family experience. Recognizes and demonstrates understanding of patient and family centered care.

PRIMARY JOB RESPONSIBILITIES

• Process new claims daily in billing software for submission to Third Party Insurance Carriers to include Primary, Secondary and Tertiary claims.
• Demonstrates the ability to determine correctness of charges and coding.
• Secure needed medical record documentation required by or requested by insurance companies when necessary to submit with claims.
• Work Account checks in Expanse to allow accounts to accurately produce claims.
• Use of critical thinking to ensure accurate and timely submission of claims.
• Work with other departments regarding coding or charge issues related to claims.
• Processes late charges on a daily basis and resubmits those charges to the insurance carriers.
• Process accounts that meet the combined accounts rules by payer to ensure timely billing of those accounts.
• Assist with Aging Accounts Receivable after processing of new claims in the AR bucket of 61-90 days
• Attend or participate in webinars / seminars concerning billing and reimbursement changes.
• Work with patients when needed to obtain resolution of accounts.
• Must be able to work effectively with others and complete tasks within specified or given deadlines.
• Demonstrates knowledge of and supports hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality statements, corporate compliance plan, customer service standards, and the code of ethical behavior.

DEPARTMENTAL AND ADDITIONAL JOB RESPONSIBILITIES

JOB SPECIFICATIONS

EDUCATION

EXPERIENCE

ESSENTIAL PHYSICAL ABILITIES / MOTOR SKILLS

These physical requirements are not exhaustive and additional job related physical requirements may be added on an as needed basis. Corrective devices may be used to meet physical requirements.

ESSENTIAL TECHNICAL ABILITIES

ESSENTIAL MENTAL ABILITIES

ESSENTIAL SENSORY REQUIREMENTS

INTERPERSONAL SKILLS

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