Job Summary: Responsible for preparation of account billings to ensure timely reimbursement. He or she ensures that all necessary information and proper documentation are provided. The Billing Clerk coordinates collections activities for delinquent accounts in order to receive overdue payments and return accounts to current payment status. The Billing Clerk responds to patient inquiries regarding account status, resolves discrepancies and prepares adjustments as necessary.
DUTIES AND RESPONSIBILITIES:
Demonstrates Competency in the Following Areas:
Compiles and completes appropriate forms, submits claims to proper agencies/insurance companies. Compiles for and reconciles the following billing documents: CHDP PM 160, SOFP Claim forms, Superbills, BCDEP Claim forms, Private insurance Claim forms, Returned Transaction Documents (RTD)and Paid Claims Activity Summary.
Contacts patients/insurance companies in a timely manner to collect unpaid insurance claims.
Verifies patient insurance/demographic information for data entry. Reviews accuracy of billing information prior to submission for payment.
Stays informed about changes in Medicare, Medicaid, insurance companies, etc. Communicates any changes in next billing department meeting.
Maintains current patient accounts and addresses in the computer system to avoid loss of claims. Always verifies patient account number.
Maintains contact as needed with clinic staff to correct or adjust any discrepancy in billing. Provides administrative expertise and technical assistance as required.
Mails all correspondence with patients and plan-payers in a timely manner.
Answers the telephone in a polite manner. Communicates information to the appropriate personnel. Responds to patient billing questions in a timely and professional manner.
Establishes payment arrangement plans according to billing and collection policies.
Demonstrates the ability to be flexible, organized, honest, and function well in stressful situations.
Interacts with patients/families and co-workers in a professional manner. Provides explanations regarding statements, insurance coverage.
Treats patients/families and co-workers with respect; ensures confidentiality of patient records.
Maintains a good working relationship within the department and with other departments.
Maintains a professional working relationship with insurance companies.
Performs other duties as assigned.
Maintains a personal daily activities tracking report at a frequency determined by the Billing Supervisor.
Responsible to bill and collect for ALL accounts for the clinic(s) that have been assigned. This includes the private payer category. Age of the past due balance has no bearing on the collection responsibility.
Ensures documentation meets current standards and policies.
Adheres to the dress code; appearance is neat and clean.
Completes annual educational requirements as determined by supervisor or CSVS policy if applicable.
Maintains regulatory requirements, including but not limited to CPR certification, annual physical assessment and PPD testing requirements.
Maintains strict confidentiality of all business information.
Maintains patient and employee confidentiality at all times.
Reports to work on time and as scheduled; completes work within designated time.
Wears identification while of duty; uses computerized punch time system correctly.
Complies with all policies and procedures outlined in the Personnel policies and procedures manual.
Complies with clinic confidentiality, safety, infection control and exposure control policies.
Attends annual review and staff meetings as scheduled.
Represents the organization in a positive and professional manner in the community.
Participates in the department's continuous Quality Assurance/Performance Improvement activities.
Complies with all organizational policies regarding ethical business practices.
Communicates and abides by CSVS' mission, vision, values, ethics and guiding principles.
Personal Effectiveness- take initiative to do more than is required in job assignment. Expresses self-confidence in stating opinions and when called upon to make decisions. Handle failure constructively with emphasis on opportunity to learn from mistakes.