Medical Billing Clerk I
Reports To: Billing Office Supervisor
Job Summary: Bills insurances and patients for services rendered by CCHCI in a timely and accurate manner.
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:
- Processes all payments received from insurance and patients on a daily basis.
- Makes appropriate adjustments to patient accounts for payments provided per contractual agreements with insurance companies, for timely payment incentives, and as directed by supervisor.
- Investigates, corrects, and resubmits claim denials in a timely manner.
- Sets up payment plans with patients for self-pay balances.
- Processes patient and payer refunds accordingly.
- Communicates with insurance companies to ensure efficient processing of claims and resubmissions.
- Communicates with patients regarding questions or grievances of their statements.
- Participates in regular staff meetings, planning meetings and other collaborative meetings as needed.
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.
- Any combination of experience and/or education that provides the necessary combination of skills.
- Participates in training and career development programs related to documentation, coding and billing compliance and updates to the Practice Management Software and to advance professional competence and 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.
- 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 and Practice Management software preferred.
- Ability to provide excellent customer service by mail, telephone, and in-person.
Work Environment & Conditions:
- Work environment is usually typical of an administrative office setting with no substantial exposure to adverse environmental conditions.
- Work occasionally requires extended hours to include early mornings, evenings and weekends.
Job Status: Full Time