Job Details : Summary :

Summary :

The Billing Clerk oversees the preparation and timely processing of accounts receivable invoices of assigned patient accounts which may include Medicaid, charity care, third party-payers, and self-pay accounts, follows up on past due accounts, and posts third party reimbursements in accordance with established regulatory requirements.

This position responds to inquiries and provides information to patients, patient's family, departmental staff, and insurance representatives.

Responsibilities :

• Maintains financial accounts on automated systems.
• Acts as liaison with Admitting Office, Business Office, and Medical Records, to provide and obtain updated billing information.
• Corrects and trends electronic denials and suspended and rejected claims from Medicaid or third-party payers.
• Investigates and resolves account discrepancies and determines potential insurance / patient refunds.
• Investigates denials, follows up with additional information, and rebills or adjusts, as necessary.
• Performs cash posting duties and posts vouchers from various commercial insurance companies; identifies and corrects errors, verifies posting when receipt received from cash.
• Photocopies and refers denials for follow up.
• Photocopies and mails Explanation of Benefits forms to patients with co-pays.
• Reviews reports for delinquent accounts over 180 days and follows up by re-billing or making account adjustments.
• Utilizes specialized computer software, including uploading data into McKesson for cash posting and EPaces for Medicaid.
• Balances checks and receipts from patients related to Medicaid spend down.
• Maintains electronic and manual financial records related to payments from patients.
• Prepares cash, checks for deposit, and maintains records of deposits.
• Maintains confidentiality of patient information.
• Effectively uses automated systems to perform work assignments.
• Performs related duties as assigned.

Qualifications / Requirements :

Experience :

1-3 years' experience in medical billing and customer service in healthcare setting required. Experience in researching patient accounts and reconciling accounts receivable issues with finance department required.

Education :

High school diploma or equivalency required.

Licenses / Certifications :

N / A

Other :

Knowledge of Medicare, Medicaid and third- party regulations, billing systems

Special Requirements :

N / A

Last updated : 2024-04-24