Billing Clerk

Job Summary: Responsible for compiling itemized CSVS bills, verifying patient insurance coverage and computing patient insurance benefits. Works closely with Medical Records and physicians' office staff. Participates in performance improvement and CQI activities.

• Verifies CSVS insurance information.
• Compiles CSVS bills, completes appropriate forms, and submits claims to proper agencies/insurance companies.
• Contacts patients/insurance companies to collect unpaid insurance claims.
• Codes patient insurance/demographic information for data entry.
• Stays informed about changes in Medicare and Medicaid.
• Maintains current patient accounts and addresses in the computer system to avoid loss of claims. Always verifies patient account number.
• Maintains a computer master list of insurance companies outlining correct name and address.
• Types and mails all correspondence in a timely manner.
• Answers the telephone in a polite manner. Communicates information to the appropriate staff.
• Demonstrates the ability to be flexible, organized and function well in stressful situations.
• Interacts with patients/families in a professional manner. Provides explanations regarding statements, insurance coverage.
• Treats patients/families with respect; ensures confidentiality of patient records.
• Maintains a good working relationship within the department and with other departments.
• Performs other duties as assigned.
• Ensures documentation meets current standards and policies.
• Supports and maintains a culture of safety and quality.
• Maintains a professional working relationship with insurance companies.

Professional Requirements:

Adheres to the dress code; appearance is neat and clean.

Completes annual educational requirements.

Maintains regulatory requirements.

Reports to work on time and as scheduled; completes work within designated time.

Wears identification while on duty; uses computerized punch time system correctly.

Attends at least 12 staff meetings annually; reads and returns all monthly staff minutes.

Participates in CQI activities.

Professional Requirements:

Adheres to the dress code; appearance is neat and clean.

Completes annual educational requirements.

Maintains regulatory requirements.

Reports to work on time and as scheduled; completes work within designated time.

Wears identification while on duty; uses computerized punch time system correctly.

Attends at least 12 staff meetings annually; reads and returns all monthly staff minutes.

Participates in CQI activities.

Regulatory Requirements:

• High school graduate or equivalent.
• Associate Degree and/or certification in Medical Billing and Coding.
• Strong proficiency with NextGen software and standard accounting platforms.

Language Skills:

• Able to communicate effectively in English and Spanish, both verbally and in writing.
• Additional languages preferred.

Skills:

• Thorough understanding of Medicare, Medicaid, HMOs, PPOs, private insurance companies.
• Basic computer knowledge, data entry skills.

Physical Demands:

• For physical demands of position, including vision, hearing, repetitive motion and environment, see following description.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.

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