Patient Account Clerk; Primary Responsibility to Business Office

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Patient Account Clerk (Primary Responsibility to Business Office) – 40 hours/week

The Patient Account Clerk performs the duties of Accounting Clerk, Posting Clerk, and Financial Clerk as assigned by the Business Office Manager. The Patient Account Clerk may also be assigned to perform certain duties usually performed by the Admitting Clerk, Collections Clerk and Medical Records Clerk on occasion.

Revenue Cycle Manager

• Must possess high school diploma or its equivalent.
• Billing education certification or equivalent experience preferred.
• Must have training or experience in business office practice, English, typing and data processing. Some office experience desirable, some medical background and hospital training desirable.
• Must possess the following skills: accurate typing, accurate filing and retrieval, telephone etiquette, tact, organizational ability, numerical ability to compile and review data to figure balances, good verbal and written communication skills.
• Must demonstrate the ability to deal with a variety of people tactfully, ability to handle confidential financial and medical information; discipline to work unsupervised; visual acuity to discern errors; ability to receive and process verbal information; ability to maintain accuracy and efficiency in performance of duties, exercise good judgment and discretion.

• Prepares and inputs data required for billing.
• Follows procedure F-61, Daily Billing Office Procedures.
• Maintains aged trial balances for patient accounts at acceptable levels of less than 10% consistently for accounts older than 120 days.
• Prepares and submits clean claims daily to various insurance companies electronically via hospital computer and or third party software or by paper if necessary.
• Works claims with missing information report, keeping it consistently below 100 accounts.
• Answers questions from patients, hospital staff and insurance companies via phone or in person.
• Identifies and resolves patient billing complaints.
• Reviews weekly patient statements list for proper insurance or private pay classification and correct balance due. If balance is determined to be due from insurance it must be rebilled promptly.
• Insures claim information is complete and accurate before billing.
• Follows up with insurance company on unpaid or rejected claims via tickler, insurance remits, phone, third party software and/or other tools available on a timely basis for all balances, including credits.
• Works credit claims timely, keeping them consistently below 100 accounts.
• Keeps individual administrative adjustments to less than .25% of rolling twelve month aged trial balance average for insurance claims on an annual basis.
• Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collects necessary information to accompany appeal.
• Obtains necessary third party source information and signed forms, if not acquired at point of service.
• Contacts third party and private pay sources to determine reason for nonpayment. Appropriately records all phone, mail and patient contacts made in patients account.
• If necessary to collect patient payment, take information over the phone or in person and give to appropriate department for posting.
• For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing by primary insurer.
• Verifies patient benefit eligibility and coverage when necessary.
• Look up ICD9/ICD
  10 diagnosis and CPT treatment codes from online services or using traditional coding references when needed.
• Communicates insurance and/or billing changes when discovered with other Patient Account Clerks.
• Performs the duties of each of the clerks in the Business…