Billing/Insurance/Collections Clerk, Cherry County Clinic

Description

Job title: Billing/Insurance/Collections Clerk

Location: Cherry County Clinic, Valentine NE

Position Summary

The Billing/Insurance/Collections Clerk is responsible for all aspects of electronic claims submission and retrieval of the same. Will work with the various insurance providers and follow up on claim status at Cherry County Hospital and Clinic.

Duties and Responsibilities

Responsibilities include but are not limited to the following:

• Answering the phone and scheduling patient visits
• Advising the patient of the privacy laws upon checking in to the clinic
• Checking patients in via the computer system so the support staff knows the patient is checked-in
• Recording personal payments, Medicare payments, Medicaid payments, and insurance payments
• Filing of Nebraska and South Dakota Medicaid forms
• Taking the mail to the post office end of day
• Flexible hours to be able to work during night clinics and Saturday mornings
• Must know the insurance industry practices for payment of claims
• Must be bondable
• Process all aspects of electronic claims submission and retrieval of the same
• Process manual claims to include welfare, all PPO's, maternity claims, denials, etc.
• Process all types of disability claims
• Process all attending physicians statements for health and life insurances
• Process all insurance correspondence and forms
• Assist patients in completion of insurance forms and/or questions of same
• Follow up with insurance companies when necessary, ensuring that claims are processed
• Maintain files in accordance with insurance correspondence
• Maintain signatures on file when necessary
• Maintain copies of all insurance cards, including insurance companies that we participate with, ensuring correct implementation in the computer
• Research all information needed to complete billing processes
• Process and distribute monthly billing statements to patients
• Follow up on all unpaid accounts
• Assist with coding and error resolution
• Work with patients in securing prepayment or monthly payment agreements
• Process preliminary work on all maternity cases to include verifying coverage with insurance company, set up payment plans, file insurance, etc.
• Identify delinquent accounts, aging period, and payment sources
• Review each account as necessary, making appropriate contacts if needed
• Making collection calls on past due accounts
• Prepare and process information for collection agency
• Follow and report status of delinquent accounts
• Identify, work with patients, and resolve any billing complaints and/or errors
• Process requests for transferred records, physician and patient
• Process death certificates
• Chart all procedures done outside the clinic including all emergency room visits, outpatient procedures, admissions, etc.
• Ready corresponding superbill, making new accounts when necessary
• Process all payments from Medicare, Welfare, Blue Cross/Blue Shield, PHS and PPO's
• Perform many other related tasks as needed or asked for.  
• Assist with receptions duties, coding and charging as required; assists with implementing transactions into computer
• Answers incoming phone calls as needed
• Pre-certifies with insurance companies if requested
• Close and balance at end of day and end of month
• Processing of various consent forms
• Processing of HCFA 1500 forms
• Processing of explanation of benefits form from insurance companies
• Coding CPT and ICD-9
• Knowledge of computer system back up and shut down
• Processing of monthly statements
• Medical records transcription
• Be able to attend educational seminars to keep up to date with industry practices
• Ensures the confidentiality of patients’ medical, personal, and financial records is maintained
• Knowledgeable of and committed to practicing Corporate Compliance policies and procedures
• Complies with Cherry County Hospital personnel policies
• Performs other duties as assigned by supervisor

Skills and Abilities Required

• Use of the telephone and computer system for processing of payments and collections
• Accounting and data skills for recording and collecting correct reimbursement 
• Good communication skills with the general public, hospital staff, and patients in person and on the phone  
• Able to make daily decisions on a regular basis by using common sense and logic 
• Organized and being able to do more than one task at once
• Has good reading and comprehension skills as it applies to learning and information regarding new equipment, procedures, and regulation
• Possesses good keyboarding skills 
• Need to have good reading, writing, and communications skills
• Ability to work under stress
• Able to adapt to change
• Must have a belief that all people are equal and are to be treated with dignity
• Must be friendly and courteous to fellow coworkers and demonstrate good public relation skills with the customers
• Must be knowledgeable of state and federal confidentiality laws, including but not limited to HIPAA, and be familiar with and follow all policies, procedures and instructions regarding the privacy and security of protected health information applicable to the position

Physical Demands and Working Conditions

• Has the ability to spend prolonged periods of time standing or sitting 
• Is able to complete repetitive movements of the hands and upper extremities
• Able to move equipment around as needed
• Must be latex tolerant
• Must be able to work occasional evenings, weekends or holidays if needed

Requirements

 Minimum Job Requirements

• High School graduate
• Experience in the use of computers and in handling the public  
• Hospital or healthcare experience as well as medical terminology preferred