Job Summary:

The Billing Clerk will process and follow up on Medicaid, Medicare or private insurance billing, review remittance advice forms to verify proper reimbursement, and adjust as necessary.

Supervisory Responsibilities:

• None.

Duties/Responsibilities:

• Checks to ensure that clinical records for patients include all information required for Medicaid, Medicare or private insurance reimbursement.  Obtain any missing information.
• Verifies correct Medicaid, Medicare or private insurance coding to ensure prompt payment.
• Inputs correct billing information and transmits electronically to the Medicaid, Medicare or private insurance carrier.
• Consults with claim clerks in the Medicaid, Medicare or private insurance office about any disputed claims and follows up on all bills not processed within usual claim period.
• Reviews remittance advice forms to determine any adjustments made to bills as submitted and consults with the Medicaid, Medicare or private insurance office.
• Post payments in client ledger.
• Adjust non-contracted rates.
• Review aging reports:  inquire about non-payment of services.
• Achieve maximum reimbursement for services provided.
• Authorizes or adjusts bills to correct errors.
• Prepares weekly and monthly reports of Medicaid, Medicare or private insurance billing.
• Conducts audits.
• Attends training to keep abreast of changes in Medicaid, Medicare or private insurance billing procedures
• Other duties as assigned.

Required Skills/Abilities: 

• Excellent verbal communication skills and hearing ability to discuss billing with medical staff, patients, and insurance company staff.
• Close attention to detail.

• Excellent interpersonal and customer service skills.        Ability to interact professionally and respectfully with clients.

• Ability to work independently.
• Availity Software experience
• Commercial and Medicare billing experience within the last 2 years is required.

Education and Experience:

• High School or equivalent required, Associates’ Degree in Billing/Coding preferred.
• 2  years’ experience billing required.
• Mental health and substance use disorder billing preferred.
• Experience in EMR software, billing systems required.

Physical Requirements: 

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.