Billing Clerk - Business Office (22588)

SCHOOLCRAFT MEMORIAL HOSPITALManistique, MI
Onsite

About The Position

Submits claims to insurance companies for hospital or RHC services. Performs follow-up process with insurance company to obtain payment or proper processing of the claim to completion.

Requirements

  • High school graduate or equivalent.
  • Knowledge of business and accounting processes.
  • Competent use of computer systems, software, and 10 key calculators.
  • Familiarity with CPT and ICD-10 coding.
  • Effective communication abilities for phone contacts with insurance payers to resolve issues.
  • Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
  • Ability to work well in a team environment.
  • Being able to triage priorities, delegate tasks if needed, and reasonably handle conflict.
  • Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections.
  • A calm manner and patience working with either patients or insurers during this process.
  • Knowledge of medical terminology likely to be encountered in medical claims.
  • Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
  • A minimum of one to three years of experience in a medical office setting.
  • Ability to multitask.
  • Heartsaver CPR Certified (obtained upon employment)

Nice To Haves

  • 3-5 years medical billing experience preferred (Critical Access Hospital and Rural Health Clinic).

Responsibilities

  • Preparing, reviewing, and transmitting claims using EMR and billing software, including electronic and paper claim processing.
  • Following up on unpaid claims within standard billing cycle timeframe.
  • Checking each insurance payment for accuracy and compliance with contract discount.
  • Calling insurance companies regarding any discrepancy in payments if necessary.
  • Coordinate insurance information with hospital/RHC billing staff.
  • Maintain automated and manual claims log assigned (this applies to Medicaid and BCBS only).
  • Identifying and billing secondary or tertiary insurances.
  • Reviewing accounts for insurance of patient follow-up.
  • Researching and appealing denied claims.
  • Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
  • Demonstrates appropriateness in meeting objectives in age specific.
  • Performs other duties as assigned.
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