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Job Description
Job Title:
Medical Billing Clerk
Reports To:
Billing Office Supervisor
Job Summary:
To timely and accurately bill insurance and patients for all services rendered by providers.
Qualifications and Requirements:
To perform this job successfully, and individual must be able to perform each essential job duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. This job description in no way implies that these are the only duties to be performed and may be modified, interpreted and/or applied in any way as necessary. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
Essential Job Duties:
- Performs all billing tasks necessary to efficiently and accurately collects all payments earned for the services rendered by providers.
- Processes and submits all charges daily for services rendered.
- Corrects and resubmits all charges filtered and held by the clearing house.
- Processes all payments received by insurance and patients on a daily basis.
- Makes appropriate and accurate adjustments to patient accounts for payments provided per contractual agreements with insurance companies and as directed by supervisor.
- Investigates and gathers appropriate information; resubmits denials in a timely manner.
- Processes and submits patient statements.
- Sets up payment plans with patients for self-pay balances.
- Makes appropriate adjustments to patient accounts for timely payment incentives.
- May perform coding duties as assigned.
- Communicates with patients, payers and CCHCI staff.
- Communicates with insurance companies to ensure efficient processing of claims and resubmissions.
- Communicates with clearing house to ensure all charges are submitted accurately.
- Communicates with patients regarding questions or grievances of their statements.
- Communicates with Health Center Management to assist in addressing unbilled encounters and unsubmitted charges and find answers to any of their billing related questions.
- Develops and improves Billing skills.
- Participates actively in routine staff meetings.
- Participates in training related to documentation, coding and billing compliance and updates to the Practice Management Software.
- Participates in collaborative meetings/trainings as available and necessary.
- Improves development through internal and external trainings provided.
- Seeks opportunities for growth and advancement within the department.
Required Education, Experience, Certificates & Licenses:
- High School diploma or GED.
- At least six months of experience in a medical setting. Experience in medical billing preferred.
- Certified Professional Coder preferred (must strive to become certified).
- Any combination of experience and/or education that provides the necessary combination of skills.
Required Language Skills:
- Ability to comprehend and compose effective instructions, correspondence and communications in English in both oral and written format.
- Bilingual in English and Spanish preferred, but not required.
Physical Requirements:
- Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
- Ability to continuously remain in a stationary position.
- Ability to occasionally move about inside the work place to access files, office machinery, etc.
- Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
- Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
- Ability to discern the nature of sounds at a normal spoken volume.
Other Required Knowledge, Skills, and Abilities:
- Ability to add, subtract, multiply and divide in all measure, using whole numbers, common fractions and decimals.
- Ability to compute rate, ratio and percent.
- Ability to skillfully gather and analyze data.
- Ability to perform variety of assignments requiring independent judgment.
- Ability to deal with challenges involving one or more variables in routine situations.
- Knowledge of billing, medical records, health plans, and community health centers preferred.
- Knowledge of ICD, CPT, and NDC codes preferred.
- Knowledge of HIPAA and Corporate Compliance rules and regulations.
- Computer literacy required with proficiency in Microsoft Excel.
- Knowledge of Electronic Health Records preferred.
- Dental Billing Experience Preferred
Work Environment & Conditions:
- Work environment is usually typical of an administrative office setting with no substantial exposure to adverse environmental conditions.
Important Notes
Knowledge of ICD and CPT Coding Preferred.