Medical Billing/Collections Clerk
Reports To: Manager/Physicians
FLSA Status: Hourly/Non-Exempt
Basic Purpose of This Job
Process electronic claims. Relieves and assists other positions as required by performing the following duties.
Duties and Responsibilities
- Processes electronic claims in a timely manner, submitting claims daily.
- Reviews claim rejections, makes corrections and resubmits the claim(s) to the correct payer.
- Communicate with physicians if there is a lack of documentation.
- Reviews reports to identify denials and edits; suggest action plans to eliminate these denials/edits in the future and determines appropriateness for appeal.
- Prepares and processes claims to be mailed to other carriers.
- Post patient and insurance accounts receivable
- Updates/Adds new insurance carriers in the PM.
- Review coding information of diagnosis and procedure billed.
- Responds timely and accurately to all incoming correspondence and inquiries from payers, patients, and other appropriate parties while remaining HIPAA compliant.
- Receives and answers inquiries or complaints concerning patient accounts, gathers information for timely resolution of issues.
- Performs Self-Pay surgery estimates and collections.
- Establishes payment arrangements based on practice guidelines if necessary.
- Prepares refund requests for any monies due to patient or insurance company as required.
- Accurate attention to detail and the ability to work independently while establishing priorities.
- Audit missing office/surgery charges and provide a list to the Providers.
- Other duties as assigned.
- Education: High School Diploma or equivalent
- Strong communication skills.
- Knowledge of coding and billing
- Working knowledge of Microsoft Windows Applications and Electronic Medical Records
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