Insurance Billing Clerk

Ohio County Healthcare•Hartford, KY

4d•Onsite

About The Position

This is a full-time position in the OCH Business Office located in Hartford, KY. The role involves managing the follow-up and collections of professional claims for clinics, assisting with claim filing, determining write-offs, and resolving coding issues. The goal is to meet monthly collection targets by keeping aged AR balances over 90 days old below 12% of total assigned insurances. Responsibilities include daily follow-up on denied and non-covered claims, utilizing payer websites and provider representatives, filing disputes and appeals, checking eligibility and claim status via provider portals, resolving claims in the denial management worklist, problem-solving with Payer Representatives, billing secondary claims, working credit balance worklists, and contacting patients for billing concerns when necessary. The position also requires participation in educational activities and staff meetings, maintaining confidentiality, and adhering to hospital policies including HIPAA guidelines. Other duties may be assigned.

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.