Insurance Billing Clerk

Ohio County Healthcare•Hartford, KY

About The Position

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

Requirements

High School Diploma or Equivalent (May be allowed to sign a GED agreement to obtain within 6-months)

Nice To Haves

Preferred experience in insurance billing and follow-up.

Responsibilities

Managing the follow-up and collections of professional claims for the clinics.
Assist in filing insurance claims, determining write offs, and resolving coding issues.
Meeting monthly collection goals by maintaining aged AR balances greater than 90 days old at under 12% of total assigned insurances.
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
Filing disputes and appeals, when necessary, with supporting documentation.
Utilizing provider portal websites to check eligibility, claim status, authorization information, member COB files, etc.
Reviewing and resolving claims in the denial management worklist
Working with Payer Representatives to problem solve ongoing issues and stay educated on any updates from the payer.
When necessary, billing secondary professional claims either electronically or by paper claim submission.
Working credit balance worklist
Contacting patients to resolve coverage or billing concerns when necessary.
Participating in educational activities and staff meetings when necessary.
Maintaining confidentiality and adheres to all hospital policies, including HIPPA guidelines.
Other duties as assigned.