What are the responsibilities and job description for the Insurance Billing Clerk position at Crawford County Memorial Hospital?
Essential Duties and Responsibilities:
- Maintains a working knowledge of applicable Federal, State and local laws and regulations, Code of Ethics, as well as other policies and procedures Insurance billing and follow-up.
- Prepare, review, and transmit claims using billing software, including electronic and paper claim processing. Post insurance payments.
- Resolves claims edits and issues to ensure proper billing and reimbursement of all assigned accounts.
- Monitors visits for denials, unpaid claims, credits, late charges and other account information. Completed follow-up in a timely manner.
- Responsible for the distribution of paper claims and verifying electronic transmission.
- Performs Series Accounts billing in a timely manner. Ensures procedures are followed to eliminate denied claims due to duplicate services dates, etc.
- Answers department telephones appropriately and handles routine questions involving billing.
- Follows up on all claim denials in a timely manner.
- Ensures departmental AR goals are met.
- Demonstrates ability to use Cerner EMR and SSI claims scrubbing software system to batch, download, and transmit claims as necessary.
- Make necessary arrangements for medical records requests, completion of additional information requests, etc. as requested by insurance companies.
- Check each insurance payment for accuracy and compliance with contract discount.
- Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
- Consistently reports to work at the scheduled time in a punctual manner and at the assigned job location.
- Regularly attend monthly staff meetings and continuing educational sessions as requested.
- Attends all required Safety Training programs and can describe his/her responsibilities related to general safety, department/service safety and specific job-related hazards.
- Follows the Hospital Exposure Control Plans/Bloodborne and Airborne Pathogens.
- Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible and courteous environment.
- Promotes effective working relations and works effectively as part of a department/unit team inter- and intra- departmentally to facilitate the department’s/unit’s ability to meet its goals and objectives.
Non-Essential Duties and Responsibilities:
- Perform other duties as assigned
Professional Requirements
- Complete annual education requirements.
- Maintain patient confidentiality at all times.
- Report to work on time and as scheduled.
- Wear identification while on duty.
- Maintain regulatory requirements, including all state, federal and local regulations.
- Represent the organization in a positive and professional manner at all times.
- Comply with all organizational policies.
- Conduct oneself as a professional in accordance with PRIDE values.
- Participate in performance improvement and continuous quality improvement activities.
- Attend regular staff meetings and in-services.
Job Requirements:
- High School Diploma required.
- One to two years prior hospital/medical office experience required.
- Prior knowledge of medical terminology preferred.
- Previous insurance experience preferred.
Organizational/Core Competencies:
- Quality Service
- Team Work
- Communication
- Respect for Others
- Time and Priority Management
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
