Insurance Billing Clerk

Essential Duties and Responsibilities

• Maintains a working knowledge of applicable Federal, State and local laws and regulations, Code of Ethics, as well as other policies and procedures Insurance billing and follow-up.
• Prepare, review, and transmit claims using billing software, including electronic and paper claim processing. Post insurance payments.
• Resolves claims edits and issues to ensure proper billing and reimbursement of all assigned accounts.
• Monitors visits for denials, unpaid claims, credits, late charges and other account information. Completed follow-up in a timely manner.
• Responsible for the distribution of paper claims and verifying electronic transmission.
• Performs Series Accounts billing in a timely manner. Ensures procedures are followed to eliminate denied claims due to duplicate services dates, etc.
• Answers department telephones appropriately and handles routine questions involving billing.
• Follows up on all claim denials in a timely manner.
  
  Ensures departmental AR goals are met.
• Demonstrates ability to use Cerner EMR and SSI claims scrubbing software system to batch, download, and transmit claims as necessary.
• Make necessary arrangements for medical records requests, completion of additional information requests, etc. as requested by insurance companies.
• Check each insurance payment for accuracy and compliance with contract discount.
• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
• Consistently reports to work at the scheduled time in a punctual manner and at the assigned job location.
• Regularly attend monthly staff meetings and continuing educational sessions as requested.
• Attends all required Safety Training programs and can describe his/her responsibilities related to general safety, department/service safety and specific job‑related hazards.
• Follows the Hospital Exposure Control Plans/Bloodborne and Airborne Pathogens.
• Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible and courteous environment.
• Promotes effective working relations and works effectively as part of a department/unit team inter‑ and intra‑departmentally to facilitate the department’s/unit’s ability to meet its goals and objectives.
• Perform other duties as assigned.

• Perform other duties as assigned.

• Complete annual education requirements.
• Maintain patient confidentiality at all times.
• Report to work on time and as scheduled.
• Wear identification while on duty.
• Maintain regulatory requirements, including all state, federal and local regulations.
• Represent the organization in a positive and professional manner at all times.
• Comply with all organizational policies.
• Conduct oneself as a professional in accordance with PRIDE values.
• Participate in performance improvement and continuous quality improvement activities.
• Attend regular staff meetings and in‑services.

• High School Diploma required.
• One to two years prior hospital/medical office experience required.
• Prior knowledge of medical terminology preferred.
• Previous insurance experience preferred.

• Quality Service
• Team Work
• Communication
• Respect for Others
• Time and Priority Management

Entry level

Full‑time

Accounting/Auditing and Finance

Medical Practices