Clerk - Insurance

Insurance Clerk The Insurance Clerk will work out of our Administration Office in Dothan. This position will be responsible for filing all private assigned insurance and billing agency fees for services contracts applicable to each division of Spectra Care.

Working hours for this position will be Monday - Thursday 7am-430pm and Friday 7am-11am.

POSITION SUMMARY/FUNCTION File all private assigned insurance on behalf of consumers. Bill all agency fee for service contracts available for consumers that are applicable to each division of Spectra Care. All billing will be accomplished by the most efficient and effective methods approved by Spectra Care. Accounts Receivables for each reimbursement source will be maintained at a level of less than 120 days.

ESSENTIAL DUTIES/RESPONSIBLITIES/FUNCTIONS/TASKS:
1. Timely filing (electronically) of insurance claims.
2. Timely unpaid claim follow-up with carriers, agencies, and Medical Records to ensure payment within 120 days.
3. Assist other Business Office staff with EOPs and necessary adjustments on consumer accounts.
4. Maintain current manuals and billing requirements for Medicare Part B, Medicaid Rehabilitative Service Contract and Physician Medicaid.
5. Assist Spectra Care staff with third party reimbursement information.
6. Regular attendance with timely arrival and departure according to scheduled hours.

Must be able to work full time with rotating assignments as necessary to include but not limited to overtime hours, nights, and/or weekends as scheduled.

To ensure client/employee safety while on duty, must remain awake during scheduled working hours.
7. Communicate with all billing staff within the Insurance Department as a team member.
8. Performs other duties as directed including but not limited to the following.

Treat others with respect and courtesy at all times.

Ensure necessary documentation is completed in a timely manner with minimal errors and in compliance with applicable guidelines and policies.

Receive and respond to inquiries of insurance matters promptly and courteously.

Meet with supervisor as established.

Follow guidelines of Spectra Care Personnel Policy, Spectra Care Clinical Policy, including but not limited to the Alabama Administrative Code, CMS, and all other applicable regulating and contractual entities.

Participate in training, workshops, in-services, and/or administrative meetings as assigned.

Ensure any necessary documentation is completed and up to date before annual leave or personal leave is taken.

Adhere to Dress Code as set forth in the Spectra Care policies and procedures.

Respond to emergency and/or crisis situations as they arise.

Functions and performs well in stressful environments and manages work related stress to ensure the safety of others.

Demonstrates a willingness to work on any unit / program at Spectra Care based on facility needs as directed.

Ability to conform to Spectra Care’s Core Values as duties are carried out daily.

Functions within professional boundaries with individuals and others.

Works in a cooperative manner with other Spectra Care employees, individuals, and/or family members.

Performs duties independently and/or with minimal supervision.

Perform all duties with the highest standard of ethics.

Works well with other staff and individuals to ensure safety of program, individuals and other staff.

Other services, tasks, functions, and responsibilities deemed necessary; not otherwise specified.

NON-ESSENTIAL DUTIES/RESPONSIBLITIES/FUNCTIONS/TASKS:

Attend departmental meetings and other assigned meetings.

Attend all required job-related/system training.

Assist in other areas needed.

Conforms to system’s policies and procedures.

ESSENTIAL QUALIFICATIONS/KNOWLEDGE/SKILLS/ABILITIES:

Administrative ability, consistent with qualifications below, requiring minimal supervision and direction.

Ability to use and understand billing software and billing websites.

Ability to interpret and understand Medicare, Medicaid and other third party claim filing requirements and coding requirements.

Position has access to a large amount of sensitive information concerning Spectra Care operations and consumers, thus the utmost discretion is required. Confidentiality must be maintained under Spectra Care policy and procedure, HIPAA law and 42 CFR.Knowledge of computerized information systems used in financial and/or accounting applications.

Ability to make minor decisions in accordance with rules and regulations and apply these to work problems.

Ability to have patience and…