Patient Accounts Insurance Billing Clerk

About the Role

The Patient Accounts Insurance Billing Clerk is responsible for filing insurance claims accurately and in a timely manner, as well as managing all related insurance correspondence. This role includes following up on outstanding or pending claims to ensure proper payment and resolution. The clerk also assists patients and customers by answering billing inquiries related to claims, payments, and account balances, providing clear and helpful information to resolve issues efficiently.

How You’ll Make an Impact

As the Patient Accounts Insurance Billing Clerk, you ensure insurance claims are filed accurately and followed through to resolution, helping reduce delays in reimbursement and improving financial accuracy for patient accounts. You take ownership of insurance correspondence by responding promptly, resolving issues, and preventing claim denials or rework whenever possible. You support patients by clearly explaining billing questions related to claims, payments, and balances, helping them better understand their accounts and feel confident in the billing process. Your attention to detail and follow-up directly contribute to smoother revenue cycle operations and a better overall patient experience.

Insurance Claims Processing and Billing

• File insurance claims daily using the billing system/editor, submitting all finalized claims electronically or by paper as required.
• Answer and resolve insurance correspondence related to claims in a timely and accurate manner.
• Work daily reports and aging summaries to follow up on unpaid or underpaid claims to ensure proper reimbursement.

Patient Accounts and Accounts Receivable Support

• Assist patients and customers with billing questions regarding claims, payments, and account balances, demonstrating empathy, patience, active listening, and strong problem-solving skills.
• Maintain account statements, track payments, and assist with balancing account and reviewing accounts receivable aging reports.

Customer Service and Communication

• Provide professional, patient-centered support by communicating clearly and effectively with patients, families, and insurance representatives.
• Apply strong time management and organizational skills while managing multiple inquiries and priorities.
• Communicate with the Office Manager regarding problem claims, unusual payments, or necessary adjustments to ensure accurate resolution.

Policies, Compliance, and Financial Processes

• Collect and verify patient financial and insurance information to support accurate billing and compliance with hospital policies and procedures.
• Follow established billing timelines, including the 6-day hold policy for outpatient records prior to coding and billing process.
• Support adherence to hospital billing procedures and ensure patients are informed of their responsibility to provide accurate and timely information.

Operational and Administrative Support

• Assist with setting up new providers, including physicians and mid-level practitioners, in the hospital financial system.
• Support organizational structure and reporting needs through accurate documentation and decision-support data.
• Contribute to operational efficiency by utilizing technology systems effectively and maintaining organized workflows.

Qualifications

• High School diploma preferred
• Associate degree highly preferred
• Prior billing experience with working knowledge of computer systems, medical terminology, and effective communication skills.

Who You Are

• Detail-oriented with a strong focus on accuracy, organization, and follow-through.
• Driven and self-motivated, demonstrating initiative and ownership in daily responsibilities.
• Ethical and professional in all interactions, maintaining integrity and confidentiality.
• Patient, empathetic, and respectful when working with patients, families, and insurance representatives.
• Strong communicator with the ability to explain billing information clearly and effectively.
• Organized and able to manage multiple priorities in a fast-paced environment.
• Problem-solver who takes initiative to research, address, and resolve claim or account issues.
• Calm under pressure and able to maintain composure in challenging or high-volume situations.
• Team-oriented while also capable of working independently with minimal supervision.

Skills & Capabilities

• Excellent written and verbal communication skills, with the ability to interact professionally with patients, insurance representatives, and internal staff.
• Strong attention to detail to ensure accuracy in claims processing, billing records, and account reconciliation.
• Highly organized with the ability to manage multiple tasks and priorities effectively in a fast-paced environment.
• Skilled in multitasking while maintaining accuracy, efficiency, and timely follow-up on claims and accounts.
• Ability to prioritize work independently while meeting deadlines and maintaining compliance with billing procedures.
• Strong problem-solving skills to identify, research, and resolve billing and insurance-related issues promptly.

Position Details

Schedule: Full-time, non-exempt, 40 hours per week. Regular and punctual attendance is required.

Physical Requirements: continual sitting and typing at a computer terminal, answering phones, some walking, twisting bending, lifting of up to 25 pounds.

Equipment: Standard office equipment; computer, copier, fax machine, calculator.

Acknowledgment

I acknowledge that I have reviewed and understand the contents of this job description. I understand that this document may be revised at the organization’s discretion and does not constitute a contract of employment. Employment is at will and may be changed with or without notice, including but not limited to duties, location, compensation, benefits, or employment status.