Billing Collections Clerk - Therapy

Overview
We are seeking a detail-oriented and organized Collections Clerk to join our team. The ideal candidate will play a crucial role in managing and processing insurance, and self pay collections for our Therapy department. This position requires a strong understanding of the medical billing system as well as attention to detail, and urgency while completing tasks.

***Prefer 1-3 years of medical billing experience.***

Required Qualifications: High School Diploma or Graduation Equivalency Degree (GED). Two years of experience in billing within the health care setting is preferred. Candidates should also be familiar with patient scheduling, medical billing, and healthcare privacy laws (HIPAA).

Key Responsibilities:

1. Maintains a professional demeanor when answering billing questions.

2. Assists in the payment posting process by investigating claims and utilizing the electronic health records to allocate funds to the proper patient account.

3. Manages patient accounts by collecting patient payments, and monitoring deficient accounts. Calls delinquent patient accounts to notify patients are being sent to collections.

4. Provides effective and timely resolution of claim denials and aged outstanding claims to obtain maximum reimbursement and avoid timely filing adjustments. Claim denials must be worked at minimum every 45 days.

5. Constructs effective appeals for denied claims based on the understanding of the denial and appeal process established by the individual insurance companies.

6. Effectively communicates with patients regarding payment plans in a timely manner.

7. Completes daily balancing for both the east and west side clinics to ensure accurate accounts receivables.

8. Manages billing inquiries and effectively communicates pertinent information to the patient or internal staff members.

9. Identifies and manages patient accounts with delinquent payments to send to the collection agencies. Notified patients of delinquent accounts prior to sending the patient to a collection agency.

10. Identifies patient accounts with credit balances and ensures timely refunds to either the insurance agency or the patient.

11. Troubleshoots any account discrepancies and allocates funds to the correct patient account.

12. Submits voided charges and re-enters as necessary.

13. Assists with other duties including checking patients in/out, scheduling, records requests, and patient phone calls as necessary.

Required Qualifications:

1. High School Diploma or Graduation Equivalency Degree (GED).

2. Candidates should be familiar with medical terminology and healthcare privacy laws (HIPAA).

3. Minimum one-year related experience in billing, clinical experience is preferred. Completion of certificate in medical billing and coding is preferred.

4. Intermediate knowledge of CPT, HCPS, ICD-10 and how they relate to processing claims

5. Knowledge of working with electronic claims and an EDI clearinghouse.

6. Experience communicating via phone and through internet portals with insurance companies is required.

7. Knowledge of working with electronic claims and an EDI clearing house.

8. Knowledge of basic insurance contracts and allowable.

9. Understanding of basic medical and insurance terminology.

10. Regular and timely attendance required to fulfill the urgency of the role.

Skills:

1. Must be highly skilled in customer service, problem solving, prioritization, and strategic thinking.

2. Follows department protocol and works well in a team environment to maximize success as a department.

3. Represent your department in a professional manner to other staff, providers, and patients.

4. Sense of urgency and commitment to timely completion of tasks.

5. Attention to detail along with a commitment to quality.

6. Must have focus and the ability to multi-task between answering phones, helping patients, and completing tasks.

7. Proficiency with basic computer programs including but not limited to Microsoft Office Suite.

8. Ability to communicate in both written and verbal format effectively and professionally.

9. All employees have the responsibility to comply with the organizational policies, procedures, code of conduct, and pertinent governmental regulations, and licensing regulations related to the position.

Physical demands:

· Sedentary position, up to 8 hours of sitting a day

· Visual, auditory, and finger dexterity required

· Must be able to lift to 30 pounds, occasionally

· Overtime or irregular hours may be required

· Occasional bending and stooping

Job Type: Full-time

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday
• No nights
• No weekends

Work Location: In person