Job Title: Billing/Insurance/Collections Clerk

Location: Cherry County  Clinic

Position Type: Full-time

Overview: Cherry County Hospital and Clinic is seeking a highly organized and detail-oriented Billing/Insurance/Collections Clerk to join our team. This position is responsible for managing all aspects of electronic claims submission, retrieval, and follow-up with various insurance providers, as well as handling self-pay accounts. The ideal candidate will have strong accounting, data management, and customer service skills.

Key Responsibilities:

• Answer incoming phone calls and assist patients with billing inquiries.
• Advise patients of privacy laws upon checking in to the clinic.
• Record payments from Medicare, Medicaid, insurance, and self-pay patients.
• File Nebraska and South Dakota Medicaid forms.
• Make collection calls on past-due accounts.
• Process electronic claims submission and retrieval.
• Handle manual claims for welfare, PPOs, maternity claims, denials, and more.
• Process disability claims and attending physician statements for health and life insurance.
• Assist patients in completing insurance forms, payor, and charity care applications.
• Follow up with insurance companies to ensure claims are processed.
• Maintain files and signatures in accordance with insurance correspondence.
• Research necessary information for billing processes and resolve billing issues.
• Process and distribute monthly billing statements to patients.
• Work with patients to secure prepayment or payment agreements.
• Handle all preliminary work for maternity cases, including insurance verification and payment plans.
• Review delinquent accounts and prepare information for collection agencies.
• Identify and resolve billing complaints or errors.
• Process consent forms, HCFA 1500 forms, and explanation of benefits from insurance companies.
• Perform coding of CPT and ICD-9.
• Maintain confidentiality of patient records and comply with HIPAA regulations.
• Attend educational seminars to stay up-to-date on industry practices.
• Perform other duties as assigned by supervisor.

Skills and Abilities:

• Excellent communication skills with the public, hospital staff, and patients.
• Ability to make decisions using common sense and logic.
• Highly organized, with the ability to multitask and manage various responsibilities.
• Strong reading and comprehension skills for new equipment, procedures, and regulations.
• Proficient keyboarding skills and attention to detail.
• Ability to work under pressure and adapt to change.
• Strong customer service skills with a friendly and courteous demeanor.
• Knowledgeable of state and federal confidentiality laws, including HIPAA, and committed to maintaining patient privacy.
• Knowledge of Corporate Compliance policies and procedures.

Physical Demands and Working Conditions:

• Requires sitting for extended periods and some standing, bending, and filing.
• Repetitive use of hands, arms, and eyes may cause strain.
• Work environment involves close proximity to others in a clean office area.
• Regular office hours Monday through Friday; may require overtime or callback during evenings and weekends.

 Minimum Job Requirements:

• High School diploma or equivalent.
• Must be bondable.
• Knowledge of insurance industry practices for claims payment.
• Experience working with computers and interacting with the public.
• Prior experience in healthcare or medical terminology is preferred.