The Claims Billing Clerk will process and follow up on all claims for the following payers – Medicare, Medicare Managed, Medicaid, Medicaid Managed, Commercial Insurance, Liability and Workers Compensation for both hospital (inpatient and outpatient) and rural health clinic services
• Reviews, corrects and electronic transmits all claims that drop into our claim product from the AR system.
• Review and post electronic remits for Medicare on our AR system.
• Reviews Medicaid remits prior to scheduled payment date for applicable corrections .
• Reviews EOB’s from all payers when reimbursement is not provided and resolves all issues.
• Submits requests for account adjustments / corrections to the Director of Patient Accounts.
• Reviews aging report to resolve credits or outstanding balances.
• Maintains the required spreadsheets for Medicare (traditional and Managed) and for Medicaid (traditional and Managed)
• Performs other related duties as assigned.
• Adheres to the facility’s Standards of Excellence.
• Must have good verbal and written communication skills to discuss billing with medical staff, HIM, patients, and Collection department.
• Must have good problem solving skills and attention to detail
• Must have good analytical and organizational skills
Education and Experience:
• High school diploma or equivalent required.
• One to two years’ experience with processing a high volume of claims.
• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.