POSITION SUMMARY:
The Billing Clerk I, under the direction of the Health Care Administrator, is responsible for processing insurance and third-party claims using current practice management software, EHR, EDR, internet tools and paper claims and reviews and inputs patient and insurance data billing and payment information and take necessary actions to ensure that payment is received from third party payors, patients, or responsible parties in a timely manner.
ESSENTIAL FUNCTIONS: (includes, but is not limited to, the following)
Reviews and inputs patient and insurance data billing and payment information and takes necessary actions to ensure that payment is received from third party payers, patients, or responsible parties in timely manner.
Verifies correct coding of various departmental encounters to ensure prompt payment.
Processes monthly statements to patients or responsible parties.
Reviews and edits rejection reports making corrections and resubmitting claims to ensure payment.
Follows up with patients and insurance companies on open accounts to determine why claims/outstanding balances have not paid.
ADDITIONAL RESPONSIBILITIES: (includes, but is not limited to, the following)
Works in conjunction with Health Center staff and departments to assure knowledge of new services, new medications and new equipment usage for billable items to obtain new sources of revenue.
All other job-related duties as assigned.
CONTACTS:
Immediate peers, peers in other departments, immediate supervisor/manager, managers in other departments, customers, outside vendors, other.
PHYSICAL REQUIREMENTS:
Position is sedentary primarily sitting and lifting a maximum of 10 pounds.
Physical Factors include constant sitting, use of near vision, and typing; frequent use of hearing, midrange and far vision; and, occasional standing and walking, carrying and lifting, climbing and stopping, reaching and manual handling, bending and use of depth perception, color vision and field of vision.
Working Conditions include occasional noise.
Potential Hazards include constant patient contact and/or computer use, frequent infectious exposure and occasional equipment.
REQUIREMENTS:
Education: High School Diploma or GED.
Associates degree in Accounting or Medical Billing preferred.
Experience: One year of experience working in a medical office preferred.
Certification/License: Must maintain a good moral character standing.
Will be required to complete and pass pre-employment drug testing.
Knowledge, Skills and Abilities: Medical coding, ICD, CPT and HCPCS knowledge required.
Knowledge of medical terminology required.
Knowledge of medical office practices required.
Must have excellent public relation/customer service skills and be able to exhibit a friendly and positive attitude.
Must be able to establish and maintain effective communication with co-workers, supervisors and the general public.
Knowledge of medical accounts receivable and billing required.
Computerized billing software skills required.
Knowledge of electronic health records required.
Must have excellent public relation/customer service skills and be able to exhibit a friendly and positive attitude.
Must be able to establish and maintain effective communication with co-workers, supervisors and the general public.
Must maintain privacy and confidentiality.
Native American preferred.
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