What are the responsibilities and job description for the Insurance Billing Clerk position at Ohio County Healthcare?
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Principal Responsibilities and Competencies:
o Managing the follow-up and collections of professional claims for the clinics.
o Assist in filing insurance claims, determining write offs, and resolving coding issues.
o Meeting monthly collection goals by maintaining aged AR balances greater than 90 days old at under 12% of total assigned insurances.
o Following up daily to resolve denied and non-covered claims/services by calling insurance companies, using payer websites, and working with provider representatives to have claims reprocessed
o Filing disputes and appeals, when necessary, with supporting documentation.
o Utilizing provider portal websites to check eligibility, claim status, authorization information, member COB files, etc.
o Reviewing and resolving claims in the denial management worklist
o Working with Payer Representatives to problem solve ongoing issues and stay educated on any updates from the payer.
o When necessary, billing secondary professional claims either electronically or by paper claim submission.
o Working credit balance worklist
o Contacting patients to resolve coverage or billing concerns when necessary.
o Participating in educational activities and staff meetings when necessary.
o Maintaining confidentiality and adheres to all hospital policies, including HIPPA guidelines.
o Other duties as assigned.
Work Environment: Office setting
Physical Demand: Walking, frequent sitting at desk, occasionally stair climbing, occasionally lifting, looking at computer screen, writing.
Schedule: Monday through Friday; 40 hours.
Travel: Occasionally travels from off-site business office to hospital or clinic locations
Qualifications:
High School Diploma or Equivalent (May be allowed to sign a GED agreement to obtain within 6-months)
Preferred experience in insurance billing and follow-up.